Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $3,454.50 / $11,444.00 / $24,108.00	Facility		$3,454.50	$11,444.00	$24,108.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $2,572.50 / $3,454.50 / $3,564.75	Professional		$2,572.50	$3,454.50	$3,564.75
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $3,858.75 / $5,880.00 / $12,862.50	Facility		$3,858.75	$5,880.00	$12,862.50
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $3,307.50 / $7,639.68 / $27,562.50	Professional		$3,307.50	$7,639.68	$27,562.50
Cigna Facility/Professional Facility Modifier Low / Median / High Price $3,822.00 / $7,811.93 / $9,489.31	Facility		$3,822.00	$7,811.93	$9,489.31
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $3,307.50 / $3,675.00 / $9,187.50	Facility		$3,307.50	$3,675.00	$9,187.50
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $3,307.50 / $3,675.00 / $9,187.50	Professional		$3,307.50	$3,675.00	$9,187.50
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 $3,675.00 / $3,675.00 / $5,145.00	Facility		$3,675.00	$3,675.00	$5,145.00
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $3,675.00 / $6,431.25 / $11,025.00	Facility		$3,675.00	$6,431.25	$11,025.00
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $3,307.50 / $4,593.75 / $5,549.25	Professional		$3,307.50	$4,593.75	$5,549.25
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $3,858.75 / $5,880.00 / $10,106.25	Facility		$3,858.75	$5,880.00	$10,106.25
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $4,064.55 / $6,782.46 / $9,001.35	Professional		$4,064.55	$6,782.46	$9,001.35
United Facility/Professional Professional Modifier Low / Median / High Price $1,543.50 / $1,543.50 / $4,116.00	Professional		$1,543.50	$1,543.50	$4,116.00