Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,786.19 / $5,917.22 / $13,567.40	Facility		$1,786.19	$5,917.22	$13,567.40
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,197.13 / $1,786.19 / $1,843.20	Professional		$1,197.13	$1,786.19	$1,843.20
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $1,995.21 / $3,118.23 / $9,025.95	Facility		$1,995.21	$3,118.23	$9,025.95
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $1,710.18 / $5,368.37 / $14,251.50	Professional		$1,710.18	$5,368.37	$14,251.50
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,976.21 / $4,039.25 / $4,906.55	Facility		$1,976.21	$4,039.25	$4,906.55
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,710.18 / $1,900.20 / $3,230.34	Facility		$1,710.18	$1,900.20	$3,230.34
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,710.18 / $1,900.20 / $4,750.50	Professional		$1,710.18	$1,900.20	$4,750.50
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 $1,900.20 / $1,900.20 / $2,660.28	Facility		$1,900.20	$1,900.20	$2,660.28
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,900.20 / $3,325.35 / $5,700.60	Facility		$1,900.20	$3,325.35	$5,700.60
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,710.18 / $2,375.25 / $2,869.30	Professional		$1,710.18	$2,375.25	$2,869.30
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $1,995.21 / $3,135.33 / $5,225.55	Facility		$1,995.21	$3,135.33	$5,225.55
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $2,101.62 / $3,712.94 / $4,417.99	Professional		$2,101.62	$3,712.94	$4,417.99
United Facility/Professional Professional Modifier Low / Median / High Price $798.08 / $798.08 / $2,128.21	Professional		$798.08	$798.08	$2,128.21