Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,833.00 / $6,072.30 / $13,923.00	Facility		$1,833.00	$6,072.30	$13,923.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $358.75 / $1,833.00 / $1,891.50	Professional		$358.75	$1,833.00	$1,891.50
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $2,047.50 / $3,412.50 / $9,262.50	Facility		$2,047.50	$3,412.50	$9,262.50
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $1,755.00 / $4,144.54 / $14,625.00	Professional		$1,755.00	$4,144.54	$14,625.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,028.00 / $4,145.10 / $5,035.14	Facility		$2,028.00	$4,145.10	$5,035.14
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,755.00 / $1,950.00 / $3,315.00	Facility		$1,755.00	$1,950.00	$3,315.00
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,755.00 / $1,950.00 / $4,875.00	Professional		$1,755.00	$1,950.00	$4,875.00
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 $1,755.00 / $2,145.00 / $3,412.50	Facility		$1,755.00	$2,145.00	$3,412.50
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,950.00 / $3,412.50 / $5,850.00	Facility		$1,950.00	$3,412.50	$5,850.00
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,755.00 / $2,340.00 / $2,769.00	Professional		$1,755.00	$2,340.00	$2,769.00
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $2,047.50 / $3,217.50 / $5,362.50	Facility		$2,047.50	$3,217.50	$5,362.50
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $2,243.61 / $3,810.52 / $4,534.09	Professional		$2,243.61	$3,810.52	$4,534.09
United Facility/Professional Professional Modifier Low / Median / High Price $819.00 / $819.00 / $2,184.00	Professional		$819.00	$819.00	$2,184.00