Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,914.39 / $4,345.67 / $4,537.10	Facility		$1,914.39	$4,345.67	$4,537.10
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,409.51 / $1,914.39 / $4,537.10	Professional		$1,409.51	$1,914.39	$4,537.10
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $2,579.52 / $5,609.84 / $13,967.65	Facility		$2,579.52	$5,609.84	$13,967.65
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $2,076.94 / $2,579.52 / $15,721.15	Professional		$2,076.94	$2,579.52	$15,721.15
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,373.71 / $2,373.71 / $2,373.71	Facility		$2,373.71	$2,373.71	$2,373.71
Cigna Facility/Professional Professional Modifier Low / Median / High Price $2,017.65 / $2,017.65 / $2,373.71	Professional		$2,017.65	$2,017.65	$2,373.71
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,514.13 / $2,945.88 / $7,647.18	Facility		$1,514.13	$2,945.88	$7,647.18
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,627.68 / $2,945.88 / $5,668.37	Professional		$1,627.68	$2,945.88	$5,668.37
Molina Facility/Professional Professional Modifier Low / Median / High Price $60.00 / $2,798.58 / $2,945.88	Professional		$60.00	$2,798.58	$2,945.88
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $2,338.38 / $2,819.01 / $2,945.88	Facility		$2,338.38	$2,819.01	$2,945.88
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $2,338.38 / $2,945.88 / $2,945.88	Professional		$2,338.38	$2,945.88	$2,945.88
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,579.52 / $3,308.37 / $5,753.68	Facility		$2,579.52	$3,308.37	$5,753.68
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $2,803.94 / $2,876.84 / $2,876.84	Facility		$2,803.94	$2,876.84	$2,876.84
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $2,340.23 / $2,504.00 / $3,240.47	Professional		$2,340.23	$2,504.00	$3,240.47
United Facility/Professional Professional Modifier Low / Median / High Price $1,332.55 / $1,998.82 / $2,542.33	Professional		$1,332.55	$1,998.82	$2,542.33
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,624.28 / $2,504.00 / $2,504.00	Professional		$1,624.28	$2,504.00	$2,504.00