Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,744.42 / $9,091.62 / $19,152.59	Facility		$2,744.42	$9,091.62	$19,152.59
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,839.35 / $2,744.42 / $2,832.01	Professional		$1,839.35	$2,744.42	$2,832.01
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $3,065.58 / $4,671.35 / $12,062.04	Facility		$3,065.58	$4,671.35	$12,062.04
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $2,886.27 / $6,066.91 / $21,897.00	Professional		$2,886.27	$6,066.91	$21,897.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $3,036.38 / $6,206.18 / $7,538.77	Facility		$3,036.38	$6,206.18	$7,538.77
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $2,627.64 / $2,919.60 / $7,299.00	Facility		$2,627.64	$2,919.60	$7,299.00
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $2,627.64 / $2,919.60 / $7,299.00	Professional		$2,627.64	$2,919.60	$7,299.00
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 $2,627.64 / $3,211.56 / $5,109.30	Facility		$2,627.64	$3,211.56	$5,109.30
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,919.60 / $5,109.30 / $8,758.79	Facility		$2,919.60	$5,109.30	$8,758.79
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $2,627.64 / $3,649.50 / $4,408.60	Professional		$2,627.64	$3,649.50	$4,408.60
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $3,065.58 / $4,791.06 / $8,028.90	Facility		$3,065.58	$4,791.06	$8,028.90
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $3,359.29 / $5,704.65 / $7,151.28	Professional		$3,359.29	$5,704.65	$7,151.28
United Facility/Professional Professional Modifier Low / Median / High Price $1,226.23 / $1,226.23 / $3,269.95	Professional		$1,226.23	$1,226.23	$3,269.95