Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,664.25 / $5,513.27 / $12,641.20	Facility		$1,664.25	$5,513.27	$12,641.20
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,115.40 / $1,664.25 / $1,717.37	Professional		$1,115.40	$1,664.25	$1,717.37
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $1,859.00 / $2,905.36 / $8,409.78	Facility		$1,859.00	$2,905.36	$8,409.78
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $1,593.43 / $5,002.52 / $13,278.60	Professional		$1,593.43	$5,002.52	$13,278.60
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,841.30 / $3,763.49 / $4,571.59	Facility		$1,841.30	$3,763.49	$4,571.59
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,593.43 / $1,770.48 / $3,009.82	Facility		$1,593.43	$1,770.48	$3,009.82
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,593.43 / $1,770.48 / $4,426.20	Professional		$1,593.43	$1,770.48	$4,426.20
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 $1,770.48 / $1,770.48 / $2,478.67	Facility		$1,770.48	$1,770.48	$2,478.67
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,770.48 / $3,098.34 / $5,311.44	Facility		$1,770.48	$3,098.34	$5,311.44
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,593.43 / $2,213.10 / $2,673.42	Professional		$1,593.43	$2,213.10	$2,673.42
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $1,859.00 / $2,921.29 / $4,868.82	Facility		$1,859.00	$2,921.29	$4,868.82
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $1,958.15 / $3,459.91 / $4,116.91	Professional		$1,958.15	$3,459.91	$4,116.91
United Facility/Professional Professional Modifier Low / Median / High Price $743.60 / $743.60 / $1,982.94	Professional		$743.60	$743.60	$1,982.94