Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $5,306.23 / $12,045.10 / $12,575.80	Facility		$5,306.23	$12,045.10	$12,575.80
Aetna Facility/Professional Professional Modifier Low / Median / High Price $4,237.14 / $5,306.23 / $12,575.80	Professional		$4,237.14	$5,306.23	$12,575.80
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $7,973.91 / $15,549.12 / $39,447.21	Facility		$7,973.91	$15,549.12	$39,447.21
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $6,014.72 / $8,275.66 / $61,641.98	Professional		$6,014.72	$8,275.66	$61,641.98
Cigna Facility/Professional Facility Modifier Low / Median / High Price $4,751.45 / $4,751.45 / $4,751.45	Facility		$4,751.45	$4,751.45	$4,751.45
Cigna Facility/Professional Professional Modifier Low / Median / High Price $4,038.73 / $4,038.73 / $4,751.45	Professional		$4,038.73	$4,038.73	$4,751.45
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $4,784.32 / $8,197.51 / $21,771.56	Facility		$4,784.32	$8,197.51	$21,771.56
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $4,789.58 / $8,328.59 / $16,135.42	Professional		$4,789.58	$8,328.59	$16,135.42
Molina Facility/Professional Professional Modifier Low / Median / High Price $6,925.33 / $7,879.50 / $8,667.45	Professional		$6,925.33	$7,879.50	$8,667.45
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $7,973.91 / $8,165.28 / $8,474.28	Facility		$7,973.91	$8,165.28	$8,474.28
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $9,967.39 / $14,273.30 / $20,206.78	Facility		$9,967.39	$14,273.30	$20,206.78
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $7,211.03 / $8,160.43 / $14,377.90	Professional		$7,211.03	$8,160.43	$14,377.90
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $7,771.84 / $7,973.91 / $7,973.91	Facility		$7,771.84	$7,973.91	$7,973.91
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $5,960.65 / $8,981.81 / $8,981.81	Professional		$5,960.65	$8,981.81	$8,981.81
United Facility/Professional Professional Modifier Low / Median / High Price $3,793.57 / $5,715.75 / $7,237.65	Professional		$3,793.57	$5,715.75	$7,237.65
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $6,450.00 / $6,940.49 / $6,940.49	Professional		$6,450.00	$6,940.49	$6,940.49