Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,745.20 / $6,231.60 / $6,506.12	Facility		$2,745.20	$6,231.60	$6,506.12
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,696.26 / $2,745.20 / $6,506.12	Professional		$1,696.26	$2,745.20	$6,506.12
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $3,698.98 / $8,044.39 / $17,790.55	Facility		$3,698.98	$8,044.39	$17,790.55
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $2,569.87 / $3,590.69 / $20,910.48	Professional		$2,569.87	$3,590.69	$20,910.48
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,782.58 / $2,782.58 / $2,782.58	Facility		$2,782.58	$2,782.58	$2,782.58
Cigna Facility/Professional Professional Modifier Low / Median / High Price $2,031.28 / $2,031.28 / $2,782.58	Professional		$2,031.28	$2,031.28	$2,782.58
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $2,134.40 / $4,071.58 / $9,713.43	Facility		$2,134.40	$4,071.58	$9,713.43
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $2,136.75 / $4,013.12 / $7,198.42	Professional		$2,136.75	$4,013.12	$7,198.42
Molina Facility/Professional Professional Modifier Low / Median / High Price $2,914.56 / $3,238.41 / $3,562.25	Professional		$2,914.56	$3,238.41	$3,562.25
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $3,312.99 / $3,731.76 / $4,224.34	Facility		$3,312.99	$3,731.76	$4,224.34
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $3,392.51 / $3,801.91 / $4,224.34	Professional		$3,392.51	$3,801.91	$4,224.34
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $3,698.98 / $4,744.13 / $8,250.66	Facility		$3,698.98	$4,744.13	$8,250.66
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $4,020.79 / $4,125.33 / $4,125.33	Facility		$4,020.79	$4,125.33	$4,125.33
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $3,355.87 / $3,590.69 / $4,646.77	Professional		$3,355.87	$3,590.69	$4,646.77
United Facility/Professional Professional Modifier Low / Median / High Price $1,692.48 / $2,550.06 / $3,229.04	Professional		$1,692.48	$2,550.06	$3,229.04
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $2,325.11 / $2,325.11 / $3,590.69	Professional		$2,325.11	$2,325.11	$3,590.69