Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $3,290.00 / $12,761.00 / $22,960.00	Facility		$3,290.00	$12,761.00	$22,960.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $2,450.00 / $3,290.00 / $3,500.00	Professional		$2,450.00	$3,290.00	$3,500.00
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $3,675.00 / $5,600.00 / $14,459.90	Facility		$3,675.00	$5,600.00	$14,459.90
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $3,500.00 / $7,169.81 / $26,250.00	Professional		$3,500.00	$7,169.81	$26,250.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $3,640.00 / $7,760.03 / $9,107.95	Facility		$3,640.00	$7,760.03	$9,107.95
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $3,150.00 / $3,500.00 / $8,750.00	Facility		$3,150.00	$3,500.00	$8,750.00
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $3,150.00 / $3,500.00 / $8,750.00	Professional		$3,150.00	$3,500.00	$8,750.00
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 $3,150.00 / $3,850.00 / $6,125.00	Facility		$3,150.00	$3,850.00	$6,125.00
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $3,500.00 / $6,125.00 / $10,500.00	Facility		$3,500.00	$6,125.00	$10,500.00
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $3,150.00 / $4,375.00 / $5,285.00	Professional		$3,150.00	$4,375.00	$5,285.00
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $3,675.00 / $5,743.50 / $9,625.00	Facility		$3,675.00	$5,743.50	$9,625.00
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $3,871.00 / $6,811.32 / $8,137.84	Professional		$3,871.00	$6,811.32	$8,137.84
United Facility/Professional Professional Modifier Low / Median / High Price $1,470.00 / $1,470.00 / $3,920.00	Professional		$1,470.00	$1,470.00	$3,920.00