Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,881.96 / $10,122.46 / $27,982.24	Facility		$1,881.96	$10,122.46	$27,982.24
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,288.89 / $1,881.96 / $2,758.40	Professional		$1,288.89	$1,881.96	$2,758.40
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $2,431.69 / $33,262.40 / $33,262.40	Facility		$2,431.69	$33,262.40	$33,262.40
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $2,480.02 / $4,229.16 / $15,672.23	Professional		$2,480.02	$4,229.16	$15,672.23
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $5,493.65 / $5,493.65 / $5,493.65	Professional		$5,493.65	$5,493.65	$5,493.65
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,614.40 / $1,771.06 / $2,018.00	Facility		$1,614.40	$1,771.06	$2,018.00
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,431.69 / $2,431.69 / $2,454.09	Facility		$2,431.69	$2,431.69	$2,454.09
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $2,592.69 / $4,085.27 / $4,889.55	Professional		$2,592.69	$4,085.27	$4,889.55
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $2,480.02 / $3,530.24 / $4,755.13	Professional		$2,480.02	$3,530.24	$4,755.13
United Facility/Professional Facility Modifier Low / Median / High Price $1,120.00 / $3,323.00 / $36,803.00	Facility		$1,120.00	$3,323.00	$36,803.00
United Facility/Professional Professional Modifier Low / Median / High Price $2,238.73 / $3,406.38 / $5,284.14	Professional		$2,238.73	$3,406.38	$5,284.14