Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,759.28 / $2,362.46 / $2,362.46	Professional		$1,759.28	$2,362.46	$2,362.46
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $7,920.00 / $23,512.50 / $23,512.50	Facility		$7,920.00	$23,512.50	$23,512.50
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $3,137.44 / $8,325.99 / $37,125.00	Professional		$3,137.44	$8,325.99	$37,125.00
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $4,455.00 / $4,950.00 / $12,375.00	Facility		$4,455.00	$4,950.00	$12,375.00
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $3,960.00 / $4,950.00 / $12,375.00	Professional		$3,960.00	$4,950.00	$12,375.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $45.00 / $50.00 / $80.00	Professional		$45.00	$50.00	$80.00
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $4,455.00 / $5,445.00 / $7,425.00	Facility		$4,455.00	$5,445.00	$7,425.00
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $2,533.36 / $4,455.00 / $7,474.50	Professional		$2,533.36	$4,455.00	$7,474.50
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $3,137.44 / $5,695.21 / $10,290.04	Professional		$3,137.44	$5,695.21	$10,290.04
United Facility/Professional Professional Modifier Low / Median / High Price $1,055.57 / $1,055.57 / $5,127.53	Professional		$1,055.57	$1,055.57	$5,127.53