Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,019.35 / $3,537.00 / $4,785.85	Facility		$2,019.35	$3,537.00	$4,785.85
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,856.69 / $2,019.35 / $4,785.85	Professional		$1,856.69	$2,019.35	$4,785.85
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $2,720.94 / $5,917.39 / $14,520.96	Facility		$2,720.94	$5,917.39	$14,520.96
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $2,173.05 / $2,785.04 / $18,492.63	Professional		$2,173.05	$2,785.04	$18,492.63
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,125.02 / $2,125.02 / $2,125.02	Facility		$2,125.02	$2,125.02	$2,125.02
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,551.26 / $1,551.26 / $2,125.02	Professional		$1,551.26	$1,551.26	$2,125.02
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,752.20 / $3,107.39 / $7,974.37	Facility		$1,752.20	$3,107.39	$7,974.37
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,754.13 / $3,107.39 / $5,910.00	Professional		$1,754.13	$3,107.39	$5,910.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $2,143.93 / $2,382.15 / $2,620.36	Professional		$2,143.93	$2,382.15	$2,620.36
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $2,466.58 / $3,034.56 / $3,713.38	Facility		$2,466.58	$3,034.56	$3,713.38
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $2,796.65 / $3,107.39 / $3,713.38	Professional		$2,796.65	$3,107.39	$3,713.38
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,720.94 / $3,489.74 / $6,069.12	Facility		$2,720.94	$3,489.74	$6,069.12
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $2,957.66 / $3,034.56 / $3,034.56	Facility		$2,957.66	$3,034.56	$3,034.56
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $2,468.55 / $2,641.28 / $3,418.13	Professional		$2,468.55	$2,641.28	$3,418.13
United Facility/Professional Professional Modifier Low / Median / High Price $1,389.43 / $2,092.96 / $2,650.84	Professional		$1,389.43	$2,092.96	$2,650.84
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,353.05 / $1,353.05 / $1,693.61	Professional		$1,353.05	$1,353.05	$1,693.61