Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,741.22 / $6,222.57 / $6,496.69	Facility		$2,741.22	$6,222.57	$6,496.69
Aetna Facility/Professional Professional Modifier Low / Median / High Price $2,466.96 / $2,741.22 / $6,496.69	Professional		$2,466.96	$2,741.22	$6,496.69
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $3,693.62 / $8,032.73 / $19,464.45	Facility		$3,693.62	$8,032.73	$19,464.45
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $2,715.87 / $3,669.84 / $24,570.97	Professional		$2,715.87	$3,669.84	$24,570.97
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,717.61 / $2,717.61 / $2,717.61	Facility		$2,717.61	$2,717.61	$2,717.61
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,983.86 / $1,983.86 / $2,717.61	Professional		$1,983.86	$1,983.86	$2,717.61
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $2,328.23 / $4,218.21 / $10,594.68	Facility		$2,328.23	$4,218.21	$10,594.68
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $2,330.79 / $4,218.21 / $7,852.14	Professional		$2,330.79	$4,218.21	$7,852.14
Molina Facility/Professional Professional Modifier Low / Median / High Price $2,910.35 / $3,233.73 / $3,557.10	Professional		$2,910.35	$3,233.73	$3,557.10
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $3,348.35 / $4,119.35 / $4,933.93	Facility		$3,348.35	$4,119.35	$4,933.93
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $3,796.39 / $4,218.21 / $4,933.93	Professional		$3,796.39	$4,218.21	$4,933.93
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $3,693.62 / $4,737.25 / $8,238.70	Facility		$3,693.62	$4,737.25	$8,238.70
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $4,014.96 / $4,119.35 / $4,119.35	Facility		$4,014.96	$4,119.35	$4,119.35
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $3,351.02 / $3,585.48 / $4,640.03	Professional		$3,351.02	$3,585.48	$4,640.03
United Facility/Professional Professional Modifier Low / Median / High Price $1,846.11 / $2,461.48 / $3,522.14	Professional		$1,846.11	$2,461.48	$3,522.14
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,951.52 / $1,951.52 / $2,260.71	Professional		$1,951.52	$1,951.52	$2,260.71