Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $3,932.15 / $13,026.30 / $29,867.50	Facility		$3,932.15	$13,026.30	$29,867.50
Aetna Facility/Professional Professional Modifier Low / Median / High Price $2,635.38 / $3,932.15 / $4,057.64	Professional		$2,635.38	$3,932.15	$4,057.64
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $4,392.29 / $6,864.52 / $19,869.87	Facility		$4,392.29	$6,864.52	$19,869.87
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $3,764.82 / $11,819.26 / $31,373.48	Professional		$3,764.82	$11,819.26	$31,373.48
Cigna Facility/Professional Facility Modifier Low / Median / High Price $4,350.45 / $8,892.04 / $10,801.35	Facility		$4,350.45	$8,892.04	$10,801.35
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $3,764.82 / $4,183.13 / $7,111.32	Facility		$3,764.82	$4,183.13	$7,111.32
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $3,764.82 / $4,183.13 / $10,457.82	Professional		$3,764.82	$4,183.13	$10,457.82
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 $4,183.13 / $4,183.13 / $5,856.38	Facility		$4,183.13	$4,183.13	$5,856.38
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $4,183.13 / $7,320.48 / $12,549.39	Facility		$4,183.13	$7,320.48	$12,549.39
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $3,764.82 / $5,228.91 / $6,316.53	Professional		$3,764.82	$5,228.91	$6,316.53
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $4,392.29 / $6,902.16 / $11,503.61	Facility		$4,392.29	$6,902.16	$11,503.61
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $4,626.54 / $8,174.58 / $9,726.86	Professional		$4,626.54	$8,174.58	$9,726.86
United Facility/Professional Professional Modifier Low / Median / High Price $1,756.91 / $1,756.91 / $4,685.10	Professional		$1,756.91	$1,756.91	$4,685.10