Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,403.26 / $12,757.68 / $27,982.24	Facility		$1,403.26	$12,757.68	$27,982.24
Aetna Facility/Professional Professional Modifier Low / Median / High Price $770.32 / $1,403.26 / $1,539.90	Professional		$770.32	$1,403.26	$1,539.90
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $9,616.27 / $16,197.56 / $30,984.11	Facility		$9,616.27	$16,197.56	$30,984.11
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $1,547.15 / $2,755.20 / $9,598.87	Professional		$1,547.15	$2,755.20	$9,598.87
Cigna Facility/Professional Facility Modifier Low / Median / High Price $5,317.97 / $5,317.97 / $8,859.68	Facility		$5,317.97	$5,317.97	$8,859.68
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,556.42 / $1,556.42 / $1,556.42	Professional		$1,556.42	$1,556.42	$1,556.42
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $5,061.89 / $8,103.97 / $24,580.18	Facility		$5,061.89	$8,103.97	$24,580.18
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $3,195.85 / $5,969.24 / $10,659.20	Professional		$3,195.85	$5,969.24	$10,659.20
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 $1,187.89 / $3,755.35 / $5,615.54	Facility		$1,187.89	$3,755.35	$5,615.54
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,503.07 / $1,813.81 / $2,270.09	Facility		$1,503.07	$1,813.81	$2,270.09
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,516.60 / $2,317.41 / $3,082.78	Professional		$1,516.60	$2,317.41	$3,082.78
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 $1,529.68 / $2,510.62 / $3,472.05	Professional		$1,529.68	$2,510.62	$3,472.05
United Facility/Professional Facility Modifier Low / Median / High Price $7,198.00 / $20,391.93 / $32,617.38	Facility		$7,198.00	$20,391.93	$32,617.38
United Facility/Professional Professional Modifier Low / Median / High Price $1,524.60 / $2,228.19 / $3,378.36	Professional		$1,524.60	$2,228.19	$3,378.36