Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $564.00 / $1,868.40 / $3,936.00	Facility		$564.00	$1,868.40	$3,936.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $210.95 / $564.00 / $582.00	Professional		$210.95	$564.00	$582.00
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $630.00 / $960.00 / $2,100.00	Facility		$630.00	$960.00	$2,100.00
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $540.00 / $1,227.14 / $4,500.00	Professional		$540.00	$1,227.14	$4,500.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $624.00 / $1,275.42 / $1,549.28	Facility		$624.00	$1,275.42	$1,549.28
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $540.00 / $600.00 / $1,777.20	Facility		$540.00	$600.00	$1,777.20
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $540.00 / $600.00 / $1,500.00	Professional		$540.00	$600.00	$1,500.00
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 $540.00 / $660.00 / $1,050.00	Facility		$540.00	$660.00	$1,050.00
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $600.00 / $1,050.00 / $1,800.00	Facility		$600.00	$1,050.00	$1,800.00
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $540.00 / $750.00 / $906.00	Professional		$540.00	$750.00	$906.00
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $630.00 / $984.60 / $1,650.00	Facility		$630.00	$984.60	$1,650.00
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $663.60 / $1,167.77 / $1,394.75	Professional		$663.60	$1,167.77	$1,394.75
United Facility/Professional Professional Modifier Low / Median / High Price $126.57 / $180.81 / $672.00	Professional		$126.57	$180.81	$672.00