Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,800.90 / $4,088.04 / $4,268.13	Facility		$1,800.90	$4,088.04	$4,268.13
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,435.23 / $1,800.90 / $4,268.13	Professional		$1,435.23	$1,800.90	$4,268.13
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $2,426.60 / $4,608.47 / $13,221.84	Facility		$2,426.60	$4,608.47	$13,221.84
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $2,009.32 / $2,426.60 / $14,294.89	Professional		$2,009.32	$2,426.60	$14,294.89
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,584.92 / $1,584.92 / $1,584.92	Facility		$1,584.92	$1,584.92	$1,584.92
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,156.99 / $1,156.99 / $1,584.92	Professional		$1,156.99	$1,156.99	$1,584.92
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,683.36 / $2,874.68 / $7,593.97	Facility		$1,683.36	$2,874.68	$7,593.97
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,778.78 / $2,921.78 / $5,382.88	Professional		$1,778.78	$2,921.78	$5,382.88
Molina Facility/Professional Professional Modifier Low / Median / High Price $1,912.02 / $2,124.46 / $2,336.91	Professional		$1,912.02	$2,124.46	$2,336.91
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $2,632.68 / $2,771.24 / $3,048.36	Facility		$2,632.68	$2,771.24	$3,048.36
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,300.35 / $2,426.60 / $5,277.27	Facility		$2,300.35	$2,426.60	$5,277.27
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $2,300.35 / $2,505.82 / $3,112.23	Professional		$2,300.35	$2,505.82	$3,112.23
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $2,637.71 / $2,706.29 / $2,706.29	Facility		$2,637.71	$2,706.29	$2,706.29
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $2,201.52 / $2,355.55 / $3,048.36	Professional		$2,201.52	$2,355.55	$3,048.36
United Facility/Professional Professional Modifier Low / Median / High Price $1,265.41 / $1,906.16 / $2,414.23	Professional		$1,265.41	$1,906.16	$2,414.23
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,705.93 / $2,355.55 / $2,355.55	Professional		$1,705.93	$2,355.55	$2,355.55