Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $3,290.00 / $12,761.00 / $22,960.00	Facility		$3,290.00	$12,761.00	$22,960.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $2,450.00 / $3,290.00 / $3,395.00	Professional		$2,450.00	$3,290.00	$3,395.00
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $3,675.00 / $5,600.00 / $12,250.00	Facility		$3,675.00	$5,600.00	$12,250.00
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $3,500.00 / $7,273.48 / $26,250.00	Professional		$3,500.00	$7,273.48	$26,250.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $3,640.00 / $7,439.93 / $9,037.44	Facility		$3,640.00	$7,439.93	$9,037.44
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $3,150.00 / $3,500.00 / $8,750.00	Facility		$3,150.00	$3,500.00	$8,750.00
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $3,150.00 / $3,500.00 / $8,750.00	Professional		$3,150.00	$3,500.00	$8,750.00
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 $3,500.00 / $3,500.00 / $4,900.00	Facility		$3,500.00	$3,500.00	$4,900.00
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $3,500.00 / $6,125.00 / $10,500.00	Facility		$3,500.00	$6,125.00	$10,500.00
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $3,150.00 / $4,375.00 / $5,285.00	Professional		$3,150.00	$4,375.00	$5,285.00
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $3,675.00 / $5,600.00 / $9,625.00	Facility		$3,675.00	$5,600.00	$9,625.00
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $4,026.86 / $6,838.17 / $8,572.24	Professional		$4,026.86	$6,838.17	$8,572.24
United Facility/Professional Professional Modifier Low / Median / High Price $1,470.00 / $1,470.00 / $3,920.00	Professional		$1,470.00	$1,470.00	$3,920.00