Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,169.71 / $10,122.46 / $27,982.24	Facility		$2,169.71	$10,122.46	$27,982.24
Aetna Facility/Professional Professional Modifier Low / Median / High Price $2,140.38 / $2,169.71 / $12,619.52	Professional		$2,140.38	$2,169.71	$12,619.52
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $2,731.49 / $31,416.35 / $37,183.86	Facility		$2,731.49	$31,416.35	$37,183.86
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $2,811.58 / $5,056.25 / $44,281.65	Professional		$2,811.58	$5,056.25	$44,281.65
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $11,859.90 / $11,859.90 / $11,859.90	Professional		$11,859.90	$11,859.90	$11,859.90
Molina Facility/Professional Professional Modifier Low / Median / High Price $45.00 / $50.00 / $50.00	Professional		$45.00	$50.00	$50.00
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,329.51 / $5,825.48 / $7,767.31	Facility		$1,329.51	$5,825.48	$7,767.31
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,731.49 / $2,731.49 / $3,152.88	Facility		$2,731.49	$2,731.49	$3,152.88
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $2,894.33 / $4,706.29 / $5,602.24	Professional		$2,894.33	$4,706.29	$5,602.24
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $2,965.58 / $11,604.83 / $16,722.66	Professional		$2,965.58	$11,604.83	$16,722.66
United Facility/Professional Facility Modifier Low / Median / High Price $1,120.00 / $3,323.00 / $36,803.00	Facility		$1,120.00	$3,323.00	$36,803.00
United Facility/Professional Professional Modifier Low / Median / High Price $1,553.86 / $3,286.80 / $5,769.83	Professional		$1,553.86	$3,286.80	$5,769.83