Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,592.80 / $5,885.66 / $6,144.94	Facility		$2,592.80	$5,885.66	$6,144.94
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,908.99 / $2,592.80 / $6,144.94	Professional		$1,908.99	$2,592.80	$6,144.94
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $3,493.63 / $7,597.82 / $18,916.50	Facility		$3,493.63	$7,597.82	$18,916.50
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $2,812.83 / $3,493.63 / $21,291.26	Professional		$2,812.83	$3,493.63	$21,291.26
Cigna Facility/Professional Facility Modifier Low / Median / High Price $3,214.74 / $3,214.74 / $3,214.74	Facility		$3,214.74	$3,214.74	$3,214.74
Cigna Facility/Professional Professional Modifier Low / Median / High Price $2,732.53 / $2,732.53 / $3,214.74	Professional		$2,732.53	$2,732.53	$3,214.74
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $2,050.82 / $3,989.83 / $10,357.50	Facility		$2,050.82	$3,989.83	$10,357.50
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $2,204.16 / $3,989.83 / $7,675.89	Professional		$2,204.16	$3,989.83	$7,675.89
Molina Facility/Professional Professional Modifier Low / Median / High Price $60.00 / $3,790.32 / $3,989.83	Professional		$60.00	$3,790.32	$3,989.83
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $3,167.04 / $3,817.97 / $3,989.83	Facility		$3,167.04	$3,817.97	$3,989.83
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $3,817.97 / $3,989.83 / $4,199.77	Professional		$3,817.97	$3,989.83	$4,199.77
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $3,493.63 / $4,480.77 / $7,792.64	Facility		$3,493.63	$4,480.77	$7,792.64
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $3,797.58 / $3,896.32 / $3,896.32	Facility		$3,797.58	$3,896.32	$3,896.32
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $3,169.57 / $3,391.36 / $4,388.81	Professional		$3,169.57	$3,391.36	$4,388.81
United Facility/Professional Professional Modifier Low / Median / High Price $1,804.68 / $2,707.02 / $3,443.10	Professional		$1,804.68	$2,707.02	$3,443.10
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $2,199.78 / $3,391.36 / $3,391.36	Professional		$2,199.78	$3,391.36	$3,391.36