Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,667.25 / $6,072.30 / $12,792.00	Facility		$1,667.25	$6,072.30	$12,792.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,105.65 / $1,649.70 / $1,702.35	Professional		$1,105.65	$1,649.70	$1,702.35
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $2,047.50 / $3,120.00 / $9,262.50	Facility		$2,047.50	$3,120.00	$9,262.50
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $1,755.00 / $4,775.04 / $14,625.00	Professional		$1,755.00	$4,775.04	$14,625.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,028.00 / $4,145.10 / $5,035.14	Facility		$2,028.00	$4,145.10	$5,035.14
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,755.00 / $1,950.00 / $4,875.00	Facility		$1,755.00	$1,950.00	$4,875.00
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,755.00 / $1,950.00 / $4,875.00	Professional		$1,755.00	$1,950.00	$4,875.00
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 $1,950.00 / $1,950.00 / $2,730.00	Facility		$1,950.00	$1,950.00	$2,730.00
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,950.00 / $3,412.50 / $5,850.00	Facility		$1,950.00	$3,412.50	$5,850.00
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,755.00 / $2,281.50 / $2,769.00	Professional		$1,755.00	$2,281.50	$2,769.00
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $2,047.50 / $3,120.00 / $5,362.50	Facility		$2,047.50	$3,120.00	$5,362.50
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $2,156.69 / $3,810.52 / $4,534.09	Professional		$2,156.69	$3,810.52	$4,534.09
United Facility/Professional Professional Modifier Low / Median / High Price $737.10 / $737.10 / $1,965.60	Professional		$737.10	$737.10	$1,965.60