Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $3,624.33 / $8,227.23 / $8,589.66	Facility		$3,624.33	$8,227.23	$8,589.66
Aetna Facility/Professional Professional Modifier Low / Median / High Price $2,389.03 / $3,624.33 / $8,589.66	Professional		$2,389.03	$3,624.33	$8,589.66
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $4,883.56 / $10,620.58 / $23,822.60	Facility		$4,883.56	$10,620.58	$23,822.60
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $3,561.11 / $4,740.59 / $28,618.56	Professional		$3,561.11	$4,740.59	$28,618.56
Cigna Facility/Professional Facility Modifier Low / Median / High Price $3,813.78 / $3,813.78 / $3,813.78	Facility		$3,813.78	$3,813.78	$3,813.78
Cigna Facility/Professional Professional Modifier Low / Median / High Price $2,784.06 / $2,784.06 / $3,813.78	Professional		$2,784.06	$2,784.06	$3,813.78
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $2,813.26 / $5,366.53 / $12,803.43	Facility		$2,813.26	$5,366.53	$12,803.43
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $2,816.35 / $5,298.30 / $9,488.94	Professional		$2,816.35	$5,298.30	$9,488.94
Molina Facility/Professional Professional Modifier Low / Median / High Price $3,847.95 / $4,275.50 / $4,703.05	Professional		$3,847.95	$4,275.50	$4,703.05
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $4,427.03 / $5,019.43 / $5,577.16	Facility		$4,427.03	$5,019.43	$5,577.16
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $4,778.05 / $5,298.30 / $5,577.16	Professional		$4,778.05	$5,298.30	$5,577.16
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $4,883.56 / $6,263.42 / $10,892.90	Facility		$4,883.56	$6,263.42	$10,892.90
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $5,308.43 / $5,446.45 / $5,446.45	Facility		$5,308.43	$5,446.45	$5,446.45
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $4,430.57 / $4,740.59 / $6,134.88	Professional		$4,430.57	$4,740.59	$6,134.88
United Facility/Professional Professional Modifier Low / Median / High Price $2,230.86 / $3,437.68 / $4,256.18	Professional		$2,230.86	$3,437.68	$4,256.18
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $2,029.58 / $2,029.58 / $2,731.85	Professional		$2,029.58	$2,029.58	$2,731.85