Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $4,700.00 / $15,570.00 / $35,700.00	Facility		$4,700.00	$15,570.00	$35,700.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $3,500.00 / $4,700.00 / $5,000.00	Professional		$3,500.00	$4,700.00	$5,000.00
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $5,250.00 / $8,205.00 / $23,750.00	Facility		$5,250.00	$8,205.00	$23,750.00
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $4,500.00 / $13,301.10 / $37,500.00	Professional		$4,500.00	$13,301.10	$37,500.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $5,200.00 / $10,628.48 / $12,910.63	Facility		$5,200.00	$10,628.48	$12,910.63
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $4,500.00 / $5,000.00 / $8,500.00	Facility		$4,500.00	$5,000.00	$8,500.00
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $4,500.00 / $5,000.00 / $12,500.00	Professional		$4,500.00	$5,000.00	$12,500.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $45.00 / $50.00 / $75.00	Professional		$45.00	$50.00	$75.00
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $5,000.00 / $5,000.00 / $7,000.00	Facility		$5,000.00	$5,000.00	$7,000.00
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $5,000.00 / $8,750.00 / $15,000.00	Facility		$5,000.00	$8,750.00	$15,000.00
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $4,500.00 / $6,250.00 / $7,550.00	Professional		$4,500.00	$6,250.00	$7,550.00
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $5,250.00 / $8,250.00 / $13,750.00	Facility		$5,250.00	$8,250.00	$13,750.00
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $5,530.00 / $9,770.86 / $11,626.25	Professional		$5,530.00	$9,770.86	$11,626.25
United Facility/Professional Professional Modifier Low / Median / High Price $2,100.00 / $2,100.00 / $5,600.00	Professional		$2,100.00	$2,100.00	$5,600.00