Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,184.16 / $4,958.04 / $5,176.46	Facility		$2,184.16	$4,958.04	$5,176.46
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,339.78 / $2,184.16 / $5,176.46	Professional		$1,339.78	$2,184.16	$5,176.46
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $2,943.02 / $6,400.37 / $14,087.74	Facility		$2,943.02	$6,400.37	$14,087.74
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $2,120.17 / $2,856.86 / $18,640.13	Professional		$2,120.17	$2,856.86	$18,640.13
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,283.76 / $2,283.76 / $2,283.76	Facility		$2,283.76	$2,283.76	$2,283.76
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,667.14 / $1,667.14 / $2,283.76	Professional		$1,667.14	$1,667.14	$2,283.76
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,778.40 / $3,361.01 / $9,209.96	Facility		$1,778.40	$3,361.01	$9,209.96
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,879.22 / $3,329.70 / $5,685.75	Professional		$1,879.22	$3,329.70	$5,685.75
Molina Facility/Professional Professional Modifier Low / Median / High Price $2,318.91 / $2,576.57 / $2,834.22	Professional		$2,318.91	$2,576.57	$2,834.22
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $2,616.76 / $3,282.24 / $3,361.01	Facility		$2,616.76	$3,282.24	$3,361.01
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $2,670.02 / $2,670.02 / $2,670.02	Professional		$2,670.02	$2,670.02	$2,670.02
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,943.02 / $3,774.58 / $6,564.48	Facility		$2,943.02	$3,774.58	$6,564.48
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $3,199.06 / $3,282.24 / $3,282.24	Facility		$3,199.06	$3,282.24	$3,282.24
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $2,670.02 / $2,856.86 / $3,697.11	Professional		$2,670.02	$2,856.86	$3,697.11
United Facility/Professional Professional Modifier Low / Median / High Price $1,336.80 / $2,014.15 / $2,550.44	Professional		$1,336.80	$2,014.15	$2,550.44
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,619.41 / $2,856.86 / $2,856.86	Professional		$1,619.41	$2,856.86	$2,856.86