Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $4,493.20 / $14,884.90 / $31,356.80	Facility		$4,493.20	$14,884.90	$31,356.80
Aetna Facility/Professional Professional Modifier Low / Median / High Price $3,011.40 / $4,493.20 / $4,636.60	Professional		$3,011.40	$4,493.20	$4,636.60
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $5,019.00 / $7,648.00 / $19,748.09	Facility		$5,019.00	$7,648.00	$19,748.09
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $4,302.00 / $9,933.14 / $35,850.00	Professional		$4,302.00	$9,933.14	$35,850.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $4,971.20 / $10,160.82 / $12,342.56	Facility		$4,971.20	$10,160.82	$12,342.56
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $4,302.00 / $4,780.00 / $11,950.00	Facility		$4,302.00	$4,780.00	$11,950.00
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $4,302.00 / $4,780.00 / $11,950.00	Professional		$4,302.00	$4,780.00	$11,950.00
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 $4,302.00 / $5,258.00 / $8,365.00	Facility		$4,302.00	$5,258.00	$8,365.00
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $4,780.00 / $8,365.00 / $14,340.00	Facility		$4,780.00	$8,365.00	$14,340.00
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $4,302.00 / $5,975.00 / $7,217.80	Professional		$4,302.00	$5,975.00	$7,217.80
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $5,019.00 / $7,648.00 / $13,145.00	Facility		$5,019.00	$7,648.00	$13,145.00
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $5,286.68 / $9,302.44 / $11,114.64	Professional		$5,286.68	$9,302.44	$11,114.64
United Facility/Professional Facility Modifier Low / Median / High Price $4,541.00 / $4,780.00 / $4,780.00	Facility		$4,541.00	$4,780.00	$4,780.00
United Facility/Professional Professional Modifier Low / Median / High Price $2,007.60 / $2,007.60 / $5,353.60	Professional		$2,007.60	$2,007.60	$5,353.60