Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,883.74 / $6,546.09 / $6,834.46	Facility		$2,883.74	$6,546.09	$6,834.46
Aetna Facility/Professional Professional Modifier Low / Median / High Price $2,298.17 / $2,883.74 / $6,834.46	Professional		$2,298.17	$2,883.74	$6,834.46
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $3,885.65 / $7,638.05 / $21,171.57	Facility		$3,885.65	$7,638.05	$21,171.57
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $3,217.45 / $3,885.65 / $22,889.87	Professional		$3,217.45	$3,885.65	$22,889.87
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,941.06 / $2,941.06 / $2,941.06	Facility		$2,941.06	$2,941.06	$2,941.06
Cigna Facility/Professional Professional Modifier Low / Median / High Price $2,146.96 / $2,146.96 / $2,941.06	Professional		$2,146.96	$2,146.96	$2,941.06
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $2,695.68 / $4,603.43 / $12,159.90	Facility		$2,695.68	$4,603.43	$12,159.90
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $2,848.28 / $4,678.52 / $8,618.41	Professional		$2,848.28	$4,678.52	$8,618.41
Molina Facility/Professional Professional Modifier Low / Median / High Price $3,061.65 / $3,401.84 / $3,742.02	Professional		$3,061.65	$3,401.84	$3,742.02
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $3,993.77 / $4,437.52 / $4,596.35	Facility		$3,993.77	$4,437.52	$4,596.35
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $3,683.49 / $3,885.65 / $8,450.36	Facility		$3,683.49	$3,885.65	$8,450.36
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $3,683.49 / $4,012.51 / $4,983.55	Professional		$3,683.49	$4,012.51	$4,983.55
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $4,223.70 / $4,333.52 / $4,333.52	Facility		$4,223.70	$4,333.52	$4,333.52
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $3,525.22 / $3,771.89 / $4,881.27	Professional		$3,525.22	$3,771.89	$4,881.27
United Facility/Professional Professional Modifier Low / Median / High Price $2,026.24 / $3,039.35 / $3,865.80	Professional		$2,026.24	$3,039.35	$3,865.80
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,510.37 / $1,510.37 / $3,771.89	Professional		$1,510.37	$1,510.37	$3,771.89