Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,222.80 / $12,757.68 / $27,982.24	Facility		$1,222.80	$12,757.68	$27,982.24
Aetna Facility/Professional Professional Modifier Low / Median / High Price $641.16 / $1,222.80 / $1,341.91	Professional		$641.16	$1,222.80	$1,341.91
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $9,616.27 / $16,188.30 / $30,984.11	Facility		$9,616.27	$16,188.30	$30,984.11
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $1,304.69 / $2,241.39 / $7,756.88	Professional		$1,304.69	$2,241.39	$7,756.88
Cigna Facility/Professional Facility Modifier Low / Median / High Price $3,738.66 / $3,738.66 / $6,228.57	Facility		$3,738.66	$3,738.66	$6,228.57
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,322.18 / $1,322.18 / $1,322.18	Professional		$1,322.18	$1,322.18	$1,322.18
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $3,937.61 / $5,697.29 / $24,580.18	Facility		$3,937.61	$5,697.29	$24,580.18
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $2,714.93 / $4,196.52 / $7,493.68	Professional		$2,714.93	$4,196.52	$7,493.68
Molina Facility/Professional Professional Modifier Low / Median / High Price $45.00 / $50.00 / $50.00	Professional		$45.00	$50.00	$50.00
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,648.73 / $3,665.73 / $4,941.97	Facility		$1,648.73	$3,665.73	$4,941.97
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,214.71 / $1,670.21 / $2,270.09	Facility		$1,214.71	$1,670.21	$2,270.09
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,250.32 / $1,923.56 / $2,491.34	Professional		$1,250.32	$1,923.56	$2,491.34
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $10,503.39 / $16,197.56 / $30,984.11	Facility		$10,503.39	$16,197.56	$30,984.11
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $1,304.69 / $2,073.92 / $2,868.13	Professional		$1,304.69	$2,073.92	$2,868.13
United Facility/Professional Facility Modifier Low / Median / High Price $2,155.00 / $3,297.00 / $12,835.00	Facility		$2,155.00	$3,297.00	$12,835.00
United Facility/Professional Professional Modifier Low / Median / High Price $1,264.57 / $1,954.57 / $2,759.06	Professional		$1,264.57	$1,954.57	$2,759.06