Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,897.04 / $4,306.28 / $4,495.97	Facility		$1,897.04	$4,306.28	$4,495.97
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,228.33 / $1,897.04 / $4,495.97	Professional		$1,228.33	$1,897.04	$4,495.97
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $2,556.14 / $5,558.98 / $12,853.25	Facility		$2,556.14	$5,558.98	$12,853.25
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $1,877.30 / $2,481.30 / $14,449.94	Professional		$1,877.30	$2,481.30	$14,449.94
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,960.76 / $1,960.76 / $1,960.76	Facility		$1,960.76	$1,960.76	$1,960.76
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,431.35 / $1,431.35 / $1,960.76	Professional		$1,431.35	$1,431.35	$1,960.76
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,545.63 / $2,919.18 / $7,034.06	Facility		$1,545.63	$2,919.18	$7,034.06
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,547.33 / $2,829.62 / $5,213.25	Professional		$1,547.33	$2,829.62	$5,213.25
Molina Facility/Professional Professional Modifier Low / Median / High Price $2,014.08 / $2,237.87 / $2,461.65	Professional		$2,014.08	$2,237.87	$2,461.65
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $2,317.19 / $2,627.26 / $2,919.18	Facility		$2,317.19	$2,627.26	$2,919.18
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $2,456.67 / $2,919.18 / $2,919.18	Professional		$2,456.67	$2,919.18	$2,919.18
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,556.14 / $3,278.37 / $5,701.52	Facility		$2,556.14	$3,278.37	$5,701.52
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $2,778.52 / $2,850.76 / $2,850.76	Facility		$2,778.52	$2,850.76	$2,850.76
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $2,319.04 / $2,481.30 / $3,211.10	Professional		$2,319.04	$2,481.30	$3,211.10
United Facility/Professional Professional Modifier Low / Median / High Price $1,225.59 / $1,838.40 / $2,338.29	Professional		$1,225.59	$1,838.40	$2,338.29
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,512.50 / $1,512.50 / $2,481.30	Professional		$1,512.50	$1,512.50	$2,481.30