Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $3,045.60 / $10,089.40 / $21,254.40	Facility		$3,045.60	$10,089.40	$21,254.40
Aetna Facility/Professional Professional Modifier Low / Median / High Price $2,041.20 / $3,045.60 / $3,142.80	Professional		$2,041.20	$3,045.60	$3,142.80
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $3,402.00 / $5,184.00 / $13,385.74	Facility		$3,402.00	$5,184.00	$13,385.74
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $3,203.02 / $6,733.28 / $24,300.00	Professional		$3,203.02	$6,733.28	$24,300.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $3,369.60 / $6,887.25 / $8,366.09	Facility		$3,369.60	$6,887.25	$8,366.09
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $2,916.00 / $3,240.00 / $8,100.00	Facility		$2,916.00	$3,240.00	$8,100.00
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $2,916.00 / $3,240.00 / $8,100.00	Professional		$2,916.00	$3,240.00	$8,100.00
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 $2,916.00 / $3,564.00 / $5,670.00	Facility		$2,916.00	$3,564.00	$5,670.00
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $3,240.00 / $5,670.00 / $9,720.00	Facility		$3,240.00	$5,670.00	$9,720.00
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $2,916.00 / $4,050.00 / $4,892.39	Professional		$2,916.00	$4,050.00	$4,892.39
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $3,402.00 / $5,316.84 / $8,910.00	Facility		$3,402.00	$5,316.84	$8,910.00
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $3,727.74 / $6,330.34 / $7,935.63	Professional		$3,727.74	$6,330.34	$7,935.63
United Facility/Professional Professional Modifier Low / Median / High Price $1,360.80 / $1,360.80 / $3,628.80	Professional		$1,360.80	$1,360.80	$3,628.80