Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,998.63 / $6,620.99 / $13,947.90	Facility		$1,998.63	$6,620.99	$13,947.90
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,339.51 / $1,998.63 / $2,919.91	Professional		$1,339.51	$1,998.63	$2,919.91
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $2,232.51 / $3,401.92 / $10,099.45	Facility		$2,232.51	$3,401.92	$10,099.45
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $1,913.58 / $4,355.47 / $15,946.50	Professional		$1,913.58	$4,355.47	$15,946.50
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,211.25 / $4,519.64 / $5,490.11	Facility		$2,211.25	$4,519.64	$5,490.11
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,913.58 / $2,126.19 / $3,614.54	Facility		$1,913.58	$2,126.19	$3,614.54
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,913.58 / $2,126.19 / $5,315.50	Professional		$1,913.58	$2,126.19	$5,315.50
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 $1,913.58 / $2,338.82 / $3,720.85	Facility		$1,913.58	$2,338.82	$3,720.85
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,126.19 / $3,720.85 / $6,591.22	Facility		$2,126.19	$3,720.85	$6,591.22
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,913.58 / $2,657.75 / $3,210.56	Professional		$1,913.58	$2,657.75	$3,210.56
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $2,232.51 / $3,401.92 / $5,847.05	Facility		$2,232.51	$3,401.92	$5,847.05
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $2,351.58 / $3,923.76 / $5,207.42	Professional		$2,351.58	$3,923.76	$5,207.42
United Facility/Professional Professional Modifier Low / Median / High Price $893.00 / $893.00 / $2,381.34	Professional		$893.00	$893.00	$2,381.34