Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $4,134.35 / $9,385.00 / $9,798.43	Facility		$4,134.35	$9,385.00	$9,798.43
Aetna Facility/Professional Professional Modifier Low / Median / High Price $3,157.26 / $4,134.35 / $9,798.43	Professional		$3,157.26	$4,134.35	$9,798.43
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $5,570.78 / $12,115.12 / $27,719.31	Facility		$5,570.78	$12,115.12	$27,719.31
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $4,131.14 / $5,407.69 / $34,789.14	Professional		$4,131.14	$5,407.69	$34,789.14
Cigna Facility/Professional Facility Modifier Low / Median / High Price $3,943.38 / $3,943.38 / $3,943.38	Facility		$3,943.38	$3,943.38	$3,943.38
Cigna Facility/Professional Professional Modifier Low / Median / High Price $2,878.67 / $2,878.67 / $3,943.38	Professional		$2,878.67	$2,878.67	$3,943.38
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $3,305.12 / $6,304.46 / $15,040.31	Facility		$3,305.12	$6,304.46	$15,040.31
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $3,308.75 / $6,095.53 / $11,147.25	Professional		$3,308.75	$6,095.53	$11,147.25
Molina Facility/Professional Professional Modifier Low / Median / High Price $4,389.44 / $4,877.16 / $5,364.87	Professional		$4,389.44	$4,877.16	$5,364.87
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $5,050.01 / $6,212.88 / $6,361.99	Facility		$5,050.01	$6,212.88	$6,361.99
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $5,054.05 / $6,361.99 / $6,361.99	Professional		$5,054.05	$6,361.99	$6,361.99
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $5,570.78 / $7,144.81 / $12,425.76	Facility		$5,570.78	$7,144.81	$12,425.76
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $6,055.44 / $6,212.88 / $6,212.88	Facility		$6,055.44	$6,212.88	$6,212.88
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $5,054.05 / $5,407.69 / $6,998.19	Professional		$5,054.05	$5,407.69	$6,998.19
United Facility/Professional Professional Modifier Low / Median / High Price $2,620.82 / $3,947.89 / $5,000.18	Professional		$2,620.82	$3,947.89	$5,000.18
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $2,237.73 / $2,237.73 / $5,407.69	Professional		$2,237.73	$2,237.73	$5,407.69