Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,635.60 / $5,418.36 / $11,414.40	Facility		$1,635.60	$5,418.36	$11,414.40
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,218.00 / $1,635.60 / $1,687.80	Professional		$1,218.00	$1,635.60	$1,687.80
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $1,827.00 / $2,784.00 / $6,090.00	Facility		$1,827.00	$2,784.00	$6,090.00
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $1,566.00 / $3,617.08 / $13,050.00	Professional		$1,566.00	$3,617.08	$13,050.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,809.60 / $3,698.71 / $4,492.89	Facility		$1,809.60	$3,698.71	$4,492.89
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,566.00 / $1,740.00 / $4,350.00	Facility		$1,566.00	$1,740.00	$4,350.00
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,566.00 / $1,740.00 / $4,350.00	Professional		$1,566.00	$1,740.00	$4,350.00
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 $1,740.00 / $1,740.00 / $3,045.00	Facility		$1,740.00	$1,740.00	$3,045.00
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,740.00 / $3,045.00 / $5,220.00	Facility		$1,740.00	$3,045.00	$5,220.00
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,566.00 / $2,175.00 / $2,627.40	Professional		$1,566.00	$2,175.00	$2,627.40
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $1,827.00 / $2,784.00 / $4,785.00	Facility		$1,827.00	$2,784.00	$4,785.00
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $1,924.44 / $3,211.43 / $4,262.05	Professional		$1,924.44	$3,211.43	$4,262.05
United Facility/Professional Professional Modifier Low / Median / High Price $730.80 / $730.80 / $1,948.80	Professional		$730.80	$730.80	$1,948.80