Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,307.62 / $5,238.30 / $5,469.06	Facility		$2,307.62	$5,238.30	$5,469.06
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,699.00 / $2,307.62 / $5,469.06	Professional		$1,699.00	$2,307.62	$5,469.06
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $3,109.37 / $6,762.15 / $16,835.74	Facility		$3,109.37	$6,762.15	$16,835.74
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $2,503.42 / $3,109.37 / $18,949.15	Professional		$2,503.42	$3,109.37	$18,949.15
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,861.13 / $2,861.13 / $2,861.13	Facility		$2,861.13	$2,861.13	$2,861.13
Cigna Facility/Professional Professional Modifier Low / Median / High Price $2,431.96 / $2,431.96 / $2,861.13	Professional		$2,431.96	$2,431.96	$2,861.13
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,825.32 / $3,551.00 / $9,217.50	Facility		$1,825.32	$3,551.00	$9,217.50
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,961.76 / $3,551.00 / $6,831.84	Professional		$1,961.76	$3,551.00	$6,831.84
Molina Facility/Professional Professional Modifier Low / Median / High Price $60.00 / $3,373.39 / $3,551.00	Professional		$60.00	$3,373.39	$3,551.00
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $2,818.68 / $3,397.99 / $3,551.00	Facility		$2,818.68	$3,397.99	$3,551.00
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $3,195.90 / $3,551.00 / $3,622.02	Professional		$3,195.90	$3,551.00	$3,622.02
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $3,109.37 / $3,987.94 / $6,935.54	Facility		$3,109.37	$3,987.94	$6,935.54
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $3,379.89 / $3,467.77 / $3,467.77	Facility		$3,379.89	$3,467.77	$3,467.77
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $2,820.94 / $3,018.35 / $3,906.10	Professional		$2,820.94	$3,018.35	$3,906.10
United Facility/Professional Professional Modifier Low / Median / High Price $1,606.17 / $2,419.46 / $3,064.36	Professional		$1,606.17	$2,419.46	$3,064.36
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,970.30 / $3,018.35 / $3,018.35	Professional		$1,970.30	$3,018.35	$3,018.35