Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,783.18 / $6,916.46 / $12,444.30	Facility		$1,783.18	$6,916.46	$12,444.30
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,195.10 / $1,783.18 / $1,840.09	Professional		$1,195.10	$1,783.18	$1,840.09
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $1,991.85 / $3,035.20 / $6,639.50	Facility		$1,991.85	$3,035.20	$6,639.50
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $1,707.30 / $3,886.19 / $14,227.50	Professional		$1,707.30	$3,886.19	$14,227.50
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,972.88 / $4,032.44 / $4,898.29	Facility		$1,972.88	$4,032.44	$4,898.29
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,707.30 / $1,897.00 / $4,742.50	Facility		$1,707.30	$1,897.00	$4,742.50
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,707.30 / $1,897.00 / $4,742.50	Professional		$1,707.30	$1,897.00	$4,742.50
Molina Facility/Professional Professional Modifier Low / Median / High Price $45.00 / $50.00 / $75.00	Professional		$45.00	$50.00	$75.00
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,707.30 / $2,086.69 / $3,319.75	Facility		$1,707.30	$2,086.69	$3,319.75
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,897.00 / $3,319.75 / $5,691.00	Facility		$1,897.00	$3,319.75	$5,691.00
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,707.30 / $2,371.25 / $2,864.47	Professional		$1,707.30	$2,371.25	$2,864.47
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $1,991.85 / $3,035.20 / $5,216.75	Facility		$1,991.85	$3,035.20	$5,216.75
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $2,098.08 / $3,691.88 / $4,411.03	Professional		$2,098.08	$3,691.88	$4,411.03
United Facility/Professional Professional Modifier Low / Median / High Price $796.74 / $796.74 / $2,124.64	Professional		$796.74	$796.74	$2,124.64