Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,589.63 / $3,608.46 / $3,767.42	Facility		$1,589.63	$3,608.46	$3,767.42
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,317.10 / $1,589.63 / $3,767.42	Professional		$1,317.10	$1,589.63	$3,767.42
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $2,141.92 / $4,767.49 / $12,133.56	Facility		$2,141.92	$4,767.49	$12,133.56
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $1,742.00 / $2,128.15 / $14,645.71	Professional		$1,742.00	$2,128.15	$14,645.71
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,665.63 / $1,665.63 / $1,665.63	Facility		$1,665.63	$1,665.63	$1,665.63
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,215.91 / $1,215.91 / $1,665.63	Professional		$1,215.91	$1,215.91	$1,665.63
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,439.62 / $2,451.23 / $6,552.18	Facility		$1,439.62	$2,451.23	$6,552.18
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,441.20 / $2,495.07 / $4,856.59	Professional		$1,441.20	$2,495.07	$4,856.59
Molina Facility/Professional Professional Modifier Low / Median / High Price $1,687.70 / $1,875.23 / $2,062.75	Professional		$1,687.70	$1,875.23	$2,062.75
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,941.69 / $2,388.82 / $2,634.20	Facility		$1,941.69	$2,388.82	$2,634.20
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $2,201.54 / $2,446.15 / $2,634.20	Professional		$2,201.54	$2,446.15	$2,634.20
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,141.92 / $2,747.14 / $4,777.64	Facility		$2,141.92	$2,747.14	$4,777.64
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $2,328.28 / $2,388.82 / $2,388.82	Facility		$2,328.28	$2,388.82	$2,388.82
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $1,943.24 / $2,079.23 / $2,690.77	Professional		$1,943.24	$2,079.23	$2,690.77
United Facility/Professional Professional Modifier Low / Median / High Price $1,141.66 / $1,720.12 / $2,178.13	Professional		$1,141.66	$1,720.12	$2,178.13
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,398.04 / $1,620.14 / $1,620.14	Professional		$1,398.04	$1,620.14	$1,620.14