Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,288.90 / $7,582.59 / $17,385.90	Facility		$2,288.90	$7,582.59	$17,385.90
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,534.05 / $2,288.90 / $2,361.94	Professional		$1,534.05	$2,288.90	$2,361.94
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $2,556.75 / $3,995.84 / $11,566.25	Facility		$2,556.75	$3,995.84	$11,566.25
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $2,191.50 / $6,879.76 / $18,262.50	Professional		$2,191.50	$6,879.76	$18,262.50
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,532.40 / $5,176.07 / $6,287.47	Facility		$2,532.40	$5,176.07	$6,287.47
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $2,191.50 / $2,435.00 / $4,139.50	Facility		$2,191.50	$2,435.00	$4,139.50
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $2,191.50 / $2,435.00 / $6,087.50	Professional		$2,191.50	$2,435.00	$6,087.50
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 $2,435.00 / $2,435.00 / $3,409.00	Facility		$2,435.00	$2,435.00	$3,409.00
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,435.00 / $4,261.25 / $7,548.50	Facility		$2,435.00	$4,261.25	$7,548.50
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $2,191.50 / $3,043.75 / $3,676.85	Professional		$2,191.50	$3,043.75	$3,676.85
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $2,556.75 / $4,017.75 / $6,696.25	Facility		$2,556.75	$4,017.75	$6,696.25
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $2,693.11 / $4,758.26 / $5,661.81	Professional		$2,693.11	$4,758.26	$5,661.81
United Facility/Professional Professional Modifier Low / Median / High Price $1,022.70 / $1,022.70 / $2,727.20	Professional		$1,022.70	$1,022.70	$2,727.20