Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $8,735.70 / $19,830.00 / $20,703.59	Facility		$8,735.70	$19,830.00	$20,703.59
Aetna Facility/Professional Professional Modifier Low / Median / High Price $8,167.42 / $8,735.70 / $20,703.59	Professional		$8,167.42	$8,735.70	$20,703.59
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $11,770.80 / $25,598.68 / $63,807.96	Facility		$11,770.80	$25,598.68	$63,807.96
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $8,575.79 / $11,695.05 / $81,347.50	Professional		$8,575.79	$11,695.05	$81,347.50
Cigna Facility/Professional Facility Modifier Low / Median / High Price $9,077.06 / $9,077.06 / $9,077.06	Facility		$9,077.06	$9,077.06	$9,077.06
Cigna Facility/Professional Professional Modifier Low / Median / High Price $6,626.25 / $6,626.25 / $9,077.06	Professional		$6,626.25	$6,626.25	$9,077.06
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $7,708.15 / $13,442.59 / $35,077.50	Facility		$7,708.15	$13,442.59	$35,077.50
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $7,716.62 / $13,547.71 / $25,995.91	Professional		$7,716.62	$13,547.71	$25,995.91
Molina Facility/Professional Professional Modifier Low / Median / High Price $9,274.68 / $10,305.20 / $11,335.72	Professional		$9,274.68	$10,305.20	$11,335.72
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $12,098.33 / $13,442.59 / $16,334.84	Facility		$12,098.33	$13,442.59	$16,334.84
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $9,572.62 / $9,572.62 / $9,572.62	Professional		$9,572.62	$9,572.62	$9,572.62
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $11,770.80 / $15,096.66 / $26,255.06	Facility		$11,770.80	$15,096.66	$26,255.06
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $12,794.86 / $13,127.53 / $13,127.53	Facility		$12,794.86	$13,127.53	$13,127.53
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $10,678.96 / $11,426.20 / $14,786.85	Professional		$10,678.96	$11,426.20	$14,786.85
United Facility/Professional Professional Modifier Low / Median / High Price $6,111.95 / $9,208.84 / $11,660.81	Professional		$6,111.95	$9,208.84	$11,660.81
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $4,615.99 / $4,615.99 / $11,426.20	Professional		$4,615.99	$4,615.99	$11,426.20