Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,649.70 / $7,109.70 / $12,792.00	Facility		$1,649.70	$7,109.70	$12,792.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,649.70 / $1,649.70 / $1,702.35	Professional		$1,649.70	$1,649.70	$1,702.35
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $2,047.50 / $3,120.00 / $7,250.61	Facility		$2,047.50	$3,120.00	$7,250.61
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $1,755.00 / $3,647.25 / $14,625.00	Professional		$1,755.00	$3,647.25	$14,625.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,028.00 / $4,145.10 / $5,035.14	Facility		$2,028.00	$4,145.10	$5,035.14
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,755.00 / $1,950.00 / $4,875.00	Facility		$1,755.00	$1,950.00	$4,875.00
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,755.00 / $1,950.00 / $4,875.00	Professional		$1,755.00	$1,950.00	$4,875.00
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 $1,755.00 / $2,145.00 / $3,412.50	Facility		$1,755.00	$2,145.00	$3,412.50
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,950.00 / $3,412.50 / $5,850.00	Facility		$1,950.00	$3,412.50	$5,850.00
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,755.00 / $2,193.75 / $2,769.00	Professional		$1,755.00	$2,193.75	$2,769.00
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $2,047.50 / $3,199.95 / $5,362.50	Facility		$2,047.50	$3,199.95	$5,362.50
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $2,156.69 / $3,429.02 / $4,449.14	Professional		$2,156.69	$3,429.02	$4,449.14
United Facility/Professional Professional Modifier Low / Median / High Price $737.10 / $819.00 / $1,950.00	Professional		$737.10	$819.00	$1,950.00