Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $3,454.50 / $11,444.00 / $24,108.00	Facility		$3,454.50	$11,444.00	$24,108.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $2,572.50 / $3,454.50 / $3,564.75	Professional		$2,572.50	$3,454.50	$3,564.75
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $3,858.75 / $5,880.00 / $15,182.90	Facility		$3,858.75	$5,880.00	$15,182.90
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $3,675.00 / $7,636.75 / $27,562.50	Professional		$3,675.00	$7,636.75	$27,562.50
Cigna Facility/Professional Facility Modifier Low / Median / High Price $3,822.00 / $7,811.93 / $9,489.31	Facility		$3,822.00	$7,811.93	$9,489.31
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $3,307.50 / $3,675.00 / $9,187.50	Facility		$3,307.50	$3,675.00	$9,187.50
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $3,307.50 / $3,675.00 / $9,187.50	Professional		$3,307.50	$3,675.00	$9,187.50
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 $3,307.50 / $4,042.50 / $6,431.25	Facility		$3,307.50	$4,042.50	$6,431.25
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $3,675.00 / $6,431.25 / $11,025.00	Facility		$3,675.00	$6,431.25	$11,025.00
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $3,307.50 / $4,593.75 / $5,549.25	Professional		$3,307.50	$4,593.75	$5,549.25
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $3,858.75 / $6,030.68 / $10,106.25	Facility		$3,858.75	$6,030.68	$10,106.25
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $4,228.32 / $7,180.47 / $9,001.35	Professional		$4,228.32	$7,180.47	$9,001.35
United Facility/Professional Professional Modifier Low / Median / High Price $1,543.50 / $1,543.50 / $4,116.00	Professional		$1,543.50	$1,543.50	$4,116.00