Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,772.56 / $6,293.71 / $6,570.97	Facility		$2,772.56	$6,293.71	$6,570.97
Aetna Facility/Professional Professional Modifier Low / Median / High Price $2,425.96 / $2,772.56 / $6,570.97	Professional		$2,425.96	$2,772.56	$6,570.97
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $3,735.84 / $8,124.56 / $19,143.40	Facility		$3,735.84	$8,124.56	$19,143.40
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $2,700.80 / $3,711.79 / $24,162.56	Professional		$2,700.80	$3,711.79	$24,162.56
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,970.85 / $2,970.85 / $2,970.85	Facility		$2,970.85	$2,970.85	$2,970.85
Cigna Facility/Professional Professional Modifier Low / Median / High Price $2,168.71 / $2,168.71 / $2,970.85	Professional		$2,168.71	$2,168.71	$2,970.85
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $2,330.05 / $4,266.43 / $10,604.06	Facility		$2,330.05	$4,266.43	$10,604.06
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $2,332.61 / $4,266.07 / $7,858.76	Professional		$2,332.61	$4,266.07	$7,858.76
Molina Facility/Professional Professional Modifier Low / Median / High Price $2,943.62 / $3,270.69 / $3,597.75	Professional		$2,943.62	$3,270.69	$3,597.75
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $3,386.61 / $4,166.43 / $4,851.92	Facility		$3,386.61	$4,166.43	$4,851.92
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $3,839.79 / $4,266.43 / $4,851.92	Professional		$3,839.79	$4,266.43	$4,851.92
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $3,735.84 / $4,791.41 / $8,332.87	Facility		$3,735.84	$4,791.41	$8,332.87
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $4,060.86 / $4,166.43 / $4,166.43	Facility		$4,060.86	$4,166.43	$4,166.43
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $3,389.32 / $3,626.47 / $4,693.07	Professional		$3,389.32	$3,626.47	$4,693.07
United Facility/Professional Professional Modifier Low / Median / High Price $1,847.62 / $2,771.43 / $3,525.02	Professional		$1,847.62	$2,771.43	$3,525.02
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,951.52 / $1,951.52 / $3,626.47	Professional		$1,951.52	$1,951.52	$3,626.47