Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $6,585.10 / $14,948.20 / $15,606.70	Facility		$6,585.10	$14,948.20	$15,606.70
Aetna Facility/Professional Professional Modifier Low / Median / High Price $5,115.25 / $6,585.10 / $15,606.70	Professional		$5,115.25	$6,585.10	$15,606.70
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $8,873.00 / $19,296.65 / $42,111.30	Facility		$8,873.00	$19,296.65	$42,111.30
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $5,830.20 / $8,714.57 / $50,947.89	Professional		$5,830.20	$8,714.57	$50,947.89
Cigna Facility/Professional Facility Modifier Low / Median / High Price $6,300.68 / $6,300.68 / $6,300.68	Facility		$6,300.68	$6,300.68	$6,300.68
Cigna Facility/Professional Professional Modifier Low / Median / High Price $4,599.50 / $4,599.50 / $6,300.68	Professional		$4,599.50	$4,599.50	$6,300.68
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $5,070.97 / $9,672.60 / $23,075.62	Facility		$5,070.97	$9,672.60	$23,075.62
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $5,076.54 / $9,626.56 / $17,102.77	Professional		$5,076.54	$9,626.56	$17,102.77
Molina Facility/Professional Professional Modifier Low / Median / High Price $6,991.39 / $7,768.22 / $8,545.04	Professional		$6,991.39	$7,768.22	$8,545.04
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $9,119.90 / $9,990.71 / $11,146.54	Facility		$9,119.90	$9,990.71	$11,146.54
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $8,049.97 / $8,049.97 / $8,049.97	Professional		$8,049.97	$8,049.97	$8,049.97
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $8,873.00 / $11,380.08 / $19,791.43	Facility		$8,873.00	$11,380.08	$19,791.43
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $9,644.95 / $9,895.71 / $9,895.71	Facility		$9,644.95	$9,895.71	$9,895.71
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $8,049.97 / $8,613.24 / $11,146.54	Professional		$8,049.97	$8,613.24	$11,146.54
United Facility/Professional Professional Modifier Low / Median / High Price $4,020.92 / $6,196.12 / $7,671.40	Professional		$4,020.92	$6,196.12	$7,671.40
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $2,706.11 / $2,706.11 / $8,613.24	Professional		$2,706.11	$2,706.11	$8,613.24