Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,576.61 / $5,848.90 / $6,106.57	Facility		$2,576.61	$5,848.90	$6,106.57
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,629.28 / $2,576.61 / $6,106.57	Professional		$1,629.28	$2,576.61	$6,106.57
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $3,471.82 / $7,550.38 / $16,910.75	Facility		$3,471.82	$7,550.38	$16,910.75
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $2,573.08 / $3,409.83 / $21,294.00	Professional		$2,573.08	$3,409.83	$21,294.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,561.34 / $2,561.34 / $2,561.34	Facility		$2,561.34	$2,561.34	$2,561.34
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,869.78 / $1,869.78 / $2,561.34	Professional		$1,869.78	$1,869.78	$2,561.34
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $2,027.93 / $3,867.87 / $9,227.81	Facility		$2,027.93	$3,867.87	$9,227.81
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $2,030.16 / $3,798.85 / $6,839.28	Professional		$2,030.16	$3,798.85	$6,839.28
Molina Facility/Professional Professional Modifier Low / Median / High Price $2,735.58 / $3,039.54 / $3,343.49	Professional		$2,735.58	$3,039.54	$3,343.49
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $3,147.26 / $3,568.43 / $3,964.92	Facility		$3,147.26	$3,568.43	$3,964.92
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $3,258.55 / $3,964.92 / $3,964.92	Professional		$3,258.55	$3,964.92	$3,964.92
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $3,471.82 / $4,452.79 / $7,743.98	Facility		$3,471.82	$4,452.79	$7,743.98
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $3,773.87 / $3,871.99 / $3,871.99	Facility		$3,773.87	$3,871.99	$3,871.99
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $3,149.78 / $3,370.18 / $4,361.41	Professional		$3,149.78	$3,370.18	$4,361.41
United Facility/Professional Professional Modifier Low / Median / High Price $1,607.95 / $1,938.20 / $3,067.76	Professional		$1,607.95	$1,938.20	$3,067.76
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,529.99 / $1,529.99 / $1,947.88	Professional		$1,529.99	$1,529.99	$1,947.88