Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,759.28 / $2,362.46 / $2,362.46	Professional		$1,759.28	$2,362.46	$2,362.46
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $7,920.00 / $11,937.94 / $11,937.94	Facility		$7,920.00	$11,937.94	$11,937.94
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $2,513.25 / $7,750.08 / $18,849.38	Professional		$2,513.25	$7,750.08	$18,849.38
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $2,010.60 / $2,513.25 / $4,272.52	Facility		$2,010.60	$2,513.25	$4,272.52
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $2,010.60 / $2,513.25 / $6,283.12	Professional		$2,010.60	$2,513.25	$6,283.12
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 $2,513.25 / $2,513.25 / $3,518.55	Facility		$2,513.25	$2,513.25	$3,518.55
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $2,533.36 / $4,455.00 / $7,474.50	Professional		$2,533.36	$4,455.00	$7,474.50
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $2,513.25 / $3,756.13 / $8,325.99	Professional		$2,513.25	$3,756.13	$8,325.99
United Facility/Professional Facility Modifier Low / Median / High Price $2,513.25 / $2,513.25 / $2,513.25	Facility		$2,513.25	$2,513.25	$2,513.25
United Facility/Professional Professional Modifier Low / Median / High Price $1,055.57 / $1,507.95 / $5,544.00	Professional		$1,055.57	$1,507.95	$5,544.00