Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,751.43 / $5,802.07 / $13,303.40	Facility		$1,751.43	$5,802.07	$13,303.40
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,173.83 / $1,751.43 / $1,807.33	Professional		$1,173.83	$1,751.43	$1,807.33
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $1,956.38 / $3,057.54 / $8,850.29	Facility		$1,956.38	$3,057.54	$8,850.29
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $1,676.90 / $5,263.98 / $13,974.15	Professional		$1,676.90	$5,263.98	$13,974.15
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,937.74 / $3,960.63 / $4,811.06	Facility		$1,937.74	$3,960.63	$4,811.06
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,676.90 / $1,863.22 / $3,167.47	Facility		$1,676.90	$1,863.22	$3,167.47
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,676.90 / $1,863.22 / $4,658.05	Professional		$1,676.90	$1,863.22	$4,658.05
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 $1,863.22 / $1,863.22 / $2,608.51	Facility		$1,863.22	$1,863.22	$2,608.51
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,863.22 / $3,260.64 / $5,589.66	Facility		$1,863.22	$3,260.64	$5,589.66
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,676.90 / $2,329.03 / $2,813.46	Professional		$1,676.90	$2,329.03	$2,813.46
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $1,956.38 / $3,074.31 / $5,123.85	Facility		$1,956.38	$3,074.31	$5,123.85
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $2,060.71 / $3,640.73 / $4,332.08	Professional		$2,060.71	$3,640.73	$4,332.08
United Facility/Professional Professional Modifier Low / Median / High Price $782.55 / $782.55 / $2,086.81	Professional		$782.55	$782.55	$2,086.81