Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,751.40 / $3,975.68 / $4,150.82	Facility		$1,751.40	$3,975.68	$4,150.82
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,395.78 / $1,751.40 / $4,150.82	Professional		$1,395.78	$1,751.40	$4,150.82
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $2,359.90 / $5,132.22 / $12,858.35	Facility		$2,359.90	$5,132.22	$12,858.35
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $1,919.21 / $2,358.52 / $13,901.92	Professional		$1,919.21	$2,358.52	$13,901.92
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,786.24 / $1,786.24 / $1,786.24	Facility		$1,786.24	$1,786.24	$1,786.24
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,303.96 / $1,303.96 / $1,786.24	Professional		$1,303.96	$1,303.96	$1,786.24
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,637.28 / $2,795.99 / $7,385.19	Facility		$1,637.28	$2,795.99	$7,385.19
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,730.11 / $2,841.84 / $5,234.76	Professional		$1,730.11	$2,841.84	$5,234.76
Molina Facility/Professional Professional Modifier Low / Median / High Price $1,859.46 / $2,066.07 / $2,272.67	Professional		$1,859.46	$2,066.07	$2,272.67
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $2,425.57 / $2,695.08 / $2,964.59	Facility		$2,425.57	$2,695.08	$2,964.59
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $1,919.20 / $1,919.20 / $1,919.20	Professional		$1,919.20	$1,919.20	$1,919.20
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,359.90 / $3,026.70 / $5,263.82	Facility		$2,359.90	$3,026.70	$5,263.82
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $2,565.21 / $2,631.91 / $2,631.91	Facility		$2,565.21	$2,631.91	$2,631.91
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $2,141.00 / $2,290.82 / $2,964.59	Professional		$2,141.00	$2,290.82	$2,964.59
United Facility/Professional Professional Modifier Low / Median / High Price $1,230.61 / $1,845.93 / $2,347.85	Professional		$1,230.61	$1,845.93	$2,347.85
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,487.71 / $2,290.82 / $2,290.82	Professional		$1,487.71	$2,290.82	$2,290.82