Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,099.60 / $6,358.44 / $11,440.30	Facility		$1,099.60	$6,358.44	$11,440.30
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,099.60 / $1,099.60 / $1,134.71	Professional		$1,099.60	$1,099.60	$1,134.71
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $1,831.15 / $2,790.32 / $6,103.83	Facility		$1,831.15	$2,790.32	$6,103.83
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $1,569.56 / $3,572.15 / $13,079.63	Professional		$1,569.56	$3,572.15	$13,079.63
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,813.71 / $3,707.11 / $4,503.10	Facility		$1,813.71	$3,707.11	$4,503.10
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,569.56 / $1,743.95 / $4,359.88	Facility		$1,569.56	$1,743.95	$4,359.88
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,569.56 / $1,743.95 / $4,359.88	Professional		$1,569.56	$1,743.95	$4,359.88
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 $1,569.56 / $1,918.35 / $3,051.91	Facility		$1,569.56	$1,918.35	$3,051.91
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,743.95 / $3,051.91 / $5,231.85	Facility		$1,743.95	$3,051.91	$5,231.85
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,569.56 / $2,179.94 / $3,226.31	Professional		$1,569.56	$2,179.94	$3,226.31
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $1,831.15 / $2,790.32 / $4,795.85	Facility		$1,831.15	$2,790.32	$4,795.85
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $1,928.81 / $2,933.22 / $4,054.99	Professional		$1,928.81	$2,933.22	$4,054.99
United Facility/Professional Professional Modifier Low / Median / High Price $491.32 / $701.88 / $1,953.22	Professional		$491.32	$701.88	$1,953.22