Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,405.02 / $3,189.40 / $3,329.90	Facility		$1,405.02	$3,189.40	$3,329.90
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,128.90 / $1,405.02 / $3,329.90	Professional		$1,128.90	$1,405.02	$3,329.90
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $1,893.18 / $4,117.22 / $9,757.10	Facility		$1,893.18	$4,117.22	$9,757.10
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $1,400.33 / $1,881.00 / $11,243.79	Professional		$1,400.33	$1,881.00	$11,243.79
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,576.65 / $1,576.65 / $1,576.65	Facility		$1,576.65	$1,576.65	$1,576.65
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,150.95 / $1,150.95 / $1,576.65	Professional		$1,150.95	$1,150.95	$1,576.65
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,180.27 / $2,162.07 / $5,371.87	Facility		$1,180.27	$2,162.07	$5,371.87
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,181.56 / $2,161.04 / $3,981.10	Professional		$1,181.56	$2,161.04	$3,981.10
Molina Facility/Professional Professional Modifier Low / Median / High Price $1,491.70 / $1,657.45 / $1,823.19	Professional		$1,491.70	$1,657.45	$1,823.19
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,716.19 / $2,111.40 / $2,257.79	Facility		$1,716.19	$2,111.40	$2,257.79
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $1,717.56 / $2,162.07 / $2,257.79	Professional		$1,717.56	$2,162.07	$2,257.79
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,893.18 / $2,428.11 / $4,222.80	Facility		$1,893.18	$2,428.11	$4,222.80
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $2,057.89 / $2,111.40 / $2,111.40	Facility		$2,057.89	$2,111.40	$2,111.40
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $1,717.56 / $1,837.76 / $2,378.28	Professional		$1,717.56	$1,837.76	$2,378.28
United Facility/Professional Professional Modifier Low / Median / High Price $936.00 / $1,409.95 / $1,785.76	Professional		$936.00	$1,409.95	$1,785.76
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,064.95 / $1,064.95 / $1,837.76	Professional		$1,064.95	$1,064.95	$1,837.76