Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,491.00 / $8,252.10 / $18,921.00	Facility		$2,491.00	$8,252.10	$18,921.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,669.50 / $2,491.00 / $2,570.50	Professional		$1,669.50	$2,491.00	$2,570.50
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $2,782.50 / $4,348.64 / $12,587.50	Facility		$2,782.50	$4,348.64	$12,587.50
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $2,385.00 / $7,487.32 / $19,875.00	Professional		$2,385.00	$7,487.32	$19,875.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,756.00 / $5,633.09 / $6,842.63	Facility		$2,756.00	$5,633.09	$6,842.63
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $2,385.00 / $2,650.00 / $4,505.00	Facility		$2,385.00	$2,650.00	$4,505.00
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $2,385.00 / $2,650.00 / $6,625.00	Professional		$2,385.00	$2,650.00	$6,625.00
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 $2,650.00 / $2,650.00 / $3,710.00	Facility		$2,650.00	$2,650.00	$3,710.00
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,650.00 / $4,637.50 / $7,950.00	Facility		$2,650.00	$4,637.50	$7,950.00
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $2,385.00 / $3,312.50 / $4,001.50	Professional		$2,385.00	$3,312.50	$4,001.50
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $2,782.50 / $4,372.50 / $7,287.50	Facility		$2,782.50	$4,372.50	$7,287.50
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $2,930.90 / $5,178.47 / $6,161.81	Professional		$2,930.90	$5,178.47	$6,161.81
United Facility/Professional Professional Modifier Low / Median / High Price $1,113.00 / $1,113.00 / $2,968.00	Professional		$1,113.00	$1,113.00	$2,968.00