Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,721.22 / $6,177.17 / $6,449.29	Facility		$2,721.22	$6,177.17	$6,449.29
Aetna Facility/Professional Professional Modifier Low / Median / High Price $2,065.06 / $2,721.22 / $6,449.29	Professional		$2,065.06	$2,721.22	$6,449.29
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $3,666.67 / $7,819.68 / $20,548.93	Facility		$3,666.67	$7,819.68	$20,548.93
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $3,056.83 / $3,698.06 / $27,258.76	Professional		$3,056.83	$3,698.06	$27,258.76
Cigna Facility/Professional Facility Modifier Low / Median / High Price $3,148.57 / $3,148.57 / $3,148.57	Facility		$3,148.57	$3,148.57	$3,148.57
Cigna Facility/Professional Professional Modifier Low / Median / High Price $2,298.46 / $2,298.46 / $3,148.57	Professional		$2,298.46	$2,298.46	$3,148.57
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $2,741.28 / $4,681.30 / $11,805.55	Facility		$2,741.28	$4,681.30	$11,805.55
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $2,896.64 / $4,757.96 / $8,764.04	Professional		$2,896.64	$4,757.96	$8,764.04
Molina Facility/Professional Professional Modifier Low / Median / High Price $2,889.11 / $3,210.13 / $3,531.14	Professional		$2,889.11	$3,210.13	$3,531.14
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $3,768.70 / $4,089.30 / $4,187.43	Facility		$3,768.70	$4,089.30	$4,187.43
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $3,475.91 / $3,666.67 / $7,974.14	Facility		$3,475.91	$3,666.67	$7,974.14
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $3,475.91 / $3,786.39 / $4,702.70	Professional		$3,475.91	$3,786.39	$4,702.70
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $3,985.67 / $4,089.30 / $4,089.30	Facility		$3,985.67	$4,089.30	$4,089.30
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $3,326.56 / $3,559.32 / $4,606.18	Professional		$3,326.56	$3,559.32	$4,606.18
United Facility/Professional Professional Modifier Low / Median / High Price $2,060.46 / $3,175.12 / $3,931.10	Professional		$2,060.46	$3,175.12	$3,931.10
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $2,831.17 / $2,831.17 / $3,559.32	Professional		$2,831.17	$2,831.17	$3,559.32