Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $4,112.39 / $13,153.90 / $20,824.50	Facility		$4,112.39	$13,153.90	$20,824.50
Aetna Facility/Professional Professional Modifier Low / Median / High Price $4,112.39 / $4,112.39 / $16,070.50	Professional		$4,112.39	$4,112.39	$16,070.50
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $3,062.43 / $4,666.56 / $12,049.64	Facility		$3,062.43	$4,666.56	$12,049.64
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $2,883.31 / $6,061.11 / $21,874.50	Professional		$2,883.31	$6,061.11	$21,874.50
Cigna Facility/Professional Facility Modifier Low / Median / High Price $3,033.26 / $6,199.80 / $7,531.03	Facility		$3,033.26	$6,199.80	$7,531.03
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $2,624.94 / $2,916.60 / $7,291.50	Facility		$2,624.94	$2,916.60	$7,291.50
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $2,624.94 / $2,916.60 / $7,291.50	Professional		$2,624.94	$2,916.60	$7,291.50
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 $2,624.94 / $3,208.26 / $5,104.05	Facility		$2,624.94	$3,208.26	$5,104.05
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,916.60 / $5,104.05 / $8,749.79	Facility		$2,916.60	$5,104.05	$8,749.79
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $2,624.94 / $3,645.75 / $4,404.07	Professional		$2,624.94	$3,645.75	$4,404.07
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $3,062.43 / $4,786.14 / $8,020.65	Facility		$3,062.43	$4,786.14	$8,020.65
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $3,355.85 / $5,698.69 / $7,143.81	Professional		$3,355.85	$5,698.69	$7,143.81
United Facility/Professional Professional Modifier Low / Median / High Price $1,224.97 / $1,224.97 / $3,266.59	Professional		$1,224.97	$1,224.97	$3,266.59