Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $4,232.93 / $13,539.40 / $21,434.90	Facility		$4,232.93	$13,539.40	$21,434.90
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,500.00 / $2,440.82 / $2,500.00	Professional		$1,500.00	$2,440.82	$2,500.00
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $3,152.19 / $4,803.34 / $12,402.83	Facility		$3,152.19	$4,803.34	$12,402.83
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $3,002.09 / $6,238.76 / $22,515.68	Professional		$3,002.09	$6,238.76	$22,515.68
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,799.28 / $4,878.39 / $7,751.78	Facility		$1,799.28	$4,878.39	$7,751.78
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $2,701.88 / $3,002.09 / $7,505.22	Facility		$2,701.88	$3,002.09	$7,505.22
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $2,701.88 / $3,002.09 / $7,505.22	Professional		$2,701.88	$3,002.09	$7,505.22
Molina Facility/Professional Professional Modifier Low / Median / High Price $75.00 / $75.00 / $75.00	Professional		$75.00	$75.00	$75.00
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $2,701.88 / $3,302.30 / $5,253.66	Facility		$2,701.88	$3,302.30	$5,253.66
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $3,002.09 / $5,253.66 / $9,006.27	Facility		$3,002.09	$5,253.66	$9,006.27
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $2,701.88 / $3,752.61 / $4,533.16	Professional		$2,701.88	$3,752.61	$4,533.16
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $3,152.19 / $4,926.43 / $8,255.75	Facility		$3,152.19	$4,926.43	$8,255.75
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $3,454.28 / $5,865.54 / $7,352.97	Professional		$3,454.28	$5,865.54	$7,352.97
United Facility/Professional Professional Modifier Low / Median / High Price $1,260.88 / $1,260.88 / $3,362.34	Professional		$1,260.88	$1,260.88	$3,362.34