Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,744.43 / $9,091.62 / $20,845.90	Facility		$2,744.43	$9,091.62	$20,845.90
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,839.35 / $2,744.43 / $2,832.01	Professional		$1,839.35	$2,744.43	$2,832.01
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $3,065.58 / $4,791.06 / $13,868.10	Facility		$3,065.58	$4,791.06	$13,868.10
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $2,627.64 / $8,249.12 / $21,897.00	Professional		$2,627.64	$8,249.12	$21,897.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $3,036.38 / $6,206.18 / $7,538.77	Facility		$3,036.38	$6,206.18	$7,538.77
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $2,627.64 / $2,919.60 / $4,963.32	Facility		$2,627.64	$2,919.60	$4,963.32
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $2,627.64 / $2,919.60 / $7,299.00	Professional		$2,627.64	$2,919.60	$7,299.00
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 $2,919.60 / $2,919.60 / $4,087.44	Facility		$2,919.60	$2,919.60	$4,087.44
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,919.60 / $5,109.30 / $8,758.79	Facility		$2,919.60	$5,109.30	$8,758.79
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $2,627.64 / $3,649.50 / $4,408.60	Professional		$2,627.64	$3,649.50	$4,408.60
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $3,065.58 / $4,817.34 / $8,028.90	Facility		$3,065.58	$4,817.34	$8,028.90
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $3,229.08 / $5,705.36 / $6,788.75	Professional		$3,229.08	$5,705.36	$6,788.75
United Facility/Professional Professional Modifier Low / Median / High Price $1,226.23 / $1,226.23 / $3,269.95	Professional		$1,226.23	$1,226.23	$3,269.95