Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,529.48 / $5,741.92 / $5,994.87	Facility		$2,529.48	$5,741.92	$5,994.87
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,701.26 / $2,529.48 / $5,994.87	Professional		$1,701.26	$2,529.48	$5,994.87
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $3,408.31 / $7,412.26 / $16,380.05	Facility		$3,408.31	$7,412.26	$16,380.05
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $2,386.92 / $3,308.53 / $19,267.33	Professional		$2,386.92	$3,308.53	$19,267.33
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,425.11 / $2,425.11 / $2,425.11	Facility		$2,425.11	$2,425.11	$2,425.11
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,770.33 / $1,770.33 / $2,425.11	Professional		$1,770.33	$1,770.33	$2,425.11
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,986.53 / $3,789.89 / $9,041.25	Facility		$1,986.53	$3,789.89	$9,041.25
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,988.71 / $3,725.07 / $6,701.09	Professional		$1,988.71	$3,725.07	$6,701.09
Molina Facility/Professional Professional Modifier Low / Median / High Price $2,685.53 / $2,983.93 / $3,282.32	Professional		$2,685.53	$2,983.93	$3,282.32
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $3,089.69 / $3,503.15 / $3,892.39	Facility		$3,089.69	$3,503.15	$3,892.39
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $3,402.51 / $3,892.39 / $3,892.39	Professional		$3,402.51	$3,892.39	$3,892.39
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $3,408.31 / $4,371.33 / $7,602.32	Facility		$3,408.31	$4,371.33	$7,602.32
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $3,704.83 / $3,801.16 / $3,801.16	Facility		$3,704.83	$3,801.16	$3,801.16
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $3,092.16 / $3,308.53 / $4,281.63	Professional		$3,092.16	$3,308.53	$4,281.63
United Facility/Professional Professional Modifier Low / Median / High Price $1,575.35 / $2,370.67 / $3,005.57	Professional		$1,575.35	$2,370.67	$3,005.57
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,766.81 / $1,766.81 / $3,308.53	Professional		$1,766.81	$1,766.81	$3,308.53