Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $3,724.00 / $12,206.90 / $25,715.20	Facility		$3,724.00	$12,206.90	$25,715.20
Aetna Facility/Professional Professional Modifier Low / Median / High Price $2,469.60 / $3,684.80 / $3,920.00	Professional		$2,469.60	$3,684.80	$3,920.00
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $3,769.50 / $5,880.00 / $16,195.09	Facility		$3,769.50	$5,880.00	$16,195.09
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $3,231.00 / $8,347.59 / $26,925.00	Professional		$3,231.00	$8,347.59	$26,925.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $3,733.60 / $7,631.25 / $9,269.83	Facility		$3,733.60	$7,631.25	$9,269.83
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $3,528.00 / $3,920.00 / $9,800.00	Facility		$3,528.00	$3,920.00	$9,800.00
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $3,528.00 / $3,920.00 / $9,800.00	Professional		$3,528.00	$3,920.00	$9,800.00
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 $3,590.00 / $3,920.00 / $4,704.00	Facility		$3,590.00	$3,920.00	$4,704.00
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $3,920.00 / $6,282.50 / $10,770.00	Facility		$3,920.00	$6,282.50	$10,770.00
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $3,231.00 / $4,638.28 / $5,919.20	Professional		$3,231.00	$4,638.28	$5,919.20
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $3,769.50 / $5,880.00 / $10,388.00	Facility		$3,769.50	$5,880.00	$10,388.00
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $3,920.00 / $7,015.43 / $8,347.59	Professional		$3,920.00	$7,015.43	$8,347.59
United Facility/Professional Professional Modifier Low / Median / High Price $1,646.40 / $1,646.40 / $4,390.39	Professional		$1,646.40	$1,646.40	$4,390.39