Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,327.90 / $1,783.18 / $1,802.15	Professional		$1,327.90	$1,783.18	$1,802.15
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $8,696.00 / $25,816.25 / $25,816.25	Facility		$8,696.00	$25,816.25	$25,816.25
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $2,371.25 / $12,637.10 / $40,762.50	Professional		$2,371.25	$12,637.10	$40,762.50
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $4,348.00 / $5,435.00 / $9,239.50	Facility		$4,348.00	$5,435.00	$9,239.50
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $4,348.00 / $5,435.00 / $13,587.50	Professional		$4,348.00	$5,435.00	$13,587.50
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 $5,435.00 / $5,435.00 / $7,609.00	Facility		$5,435.00	$5,435.00	$7,609.00
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,912.18 / $2,466.10 / $7,255.72	Professional		$1,912.18	$2,466.10	$7,255.72
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $5,435.00 / $9,228.62 / $12,637.10	Professional		$5,435.00	$9,228.62	$12,637.10
United Facility/Professional Professional Modifier Low / Median / High Price $796.74 / $1,138.20 / $6,087.20	Professional		$796.74	$1,138.20	$6,087.20