Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,903.94 / $6,591.94 / $6,882.34	Facility		$2,903.94	$6,591.94	$6,882.34
Aetna Facility/Professional Professional Modifier Low / Median / High Price $2,138.07 / $2,903.94 / $6,882.34	Professional		$2,138.07	$2,903.94	$6,882.34
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $3,912.87 / $8,509.57 / $21,186.55	Facility		$3,912.87	$8,509.57	$21,186.55
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $3,150.38 / $3,887.69 / $23,846.16	Professional		$3,150.38	$3,887.69	$23,846.16
Cigna Facility/Professional Facility Modifier Low / Median / High Price $3,600.52 / $3,600.52 / $3,600.52	Facility		$3,600.52	$3,600.52	$3,600.52
Cigna Facility/Professional Professional Modifier Low / Median / High Price $3,060.44 / $3,060.44 / $3,600.52	Professional		$3,060.44	$3,060.44	$3,600.52
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $2,296.82 / $4,468.60 / $11,599.68	Facility		$2,296.82	$4,468.60	$11,599.68
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $2,468.64 / $4,468.60 / $8,597.71	Professional		$2,468.64	$4,468.60	$8,597.71
Molina Facility/Professional Professional Modifier Low / Median / High Price $60.00 / $4,245.18 / $4,468.60	Professional		$60.00	$4,245.18	$4,468.60
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $3,547.09 / $4,276.13 / $4,468.60	Facility		$3,547.09	$4,276.13	$4,468.60
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $4,021.75 / $4,468.60 / $4,468.60	Professional		$4,021.75	$4,468.60	$4,468.60
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $3,912.87 / $5,018.46 / $8,727.76	Facility		$3,912.87	$5,018.46	$8,727.76
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $4,253.29 / $4,363.88 / $4,363.88	Facility		$4,253.29	$4,363.88	$4,363.88
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $3,549.92 / $3,798.32 / $4,915.47	Professional		$3,549.92	$3,798.32	$4,915.47
United Facility/Professional Professional Modifier Low / Median / High Price $2,021.25 / $2,899.74 / $3,856.28	Professional		$2,021.25	$2,899.74	$3,856.28
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $2,478.96 / $3,798.32 / $3,798.32	Professional		$2,478.96	$3,798.32	$3,798.32