Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $4,500.00 / $10,596.56 / $22,024.00	Facility		$4,500.00	$10,596.56	$22,024.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $5,201.63 / $6,937.85 / $11,350.02	Professional		$5,201.63	$6,937.85	$11,350.02
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $20,135.12 / $31,176.05 / $59,636.26	Facility		$20,135.12	$31,176.05	$59,636.26
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $8,396.85 / $14,419.81 / $53,941.28	Professional		$8,396.85	$14,419.81	$53,941.28
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $8,927.52 / $13,474.70 / $52,962.21	Facility		$8,927.52	$13,474.70	$52,962.21
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $7,316.91 / $10,060.41 / $18,908.56	Professional		$7,316.91	$10,060.41	$18,908.56
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 $838.65 / $8,323.64 / $12,165.32	Facility		$838.65	$8,323.64	$12,165.32
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $7,662.04 / $7,662.04 / $8,446.73	Facility		$7,662.04	$7,662.04	$8,446.73
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $8,777.67 / $13,830.88 / $16,765.93	Professional		$8,777.67	$13,830.88	$16,765.93
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $23,813.62 / $31,176.05 / $59,636.26	Facility		$23,813.62	$31,176.05	$59,636.26
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $8,396.85 / $12,150.73 / $16,366.70	Professional		$8,396.85	$12,150.73	$16,366.70
United Facility/Professional Facility Modifier Low / Median / High Price $3,340.00 / $13,441.00 / $26,100.00	Facility		$3,340.00	$13,441.00	$26,100.00
United Facility/Professional Professional Modifier Low / Median / High Price $12,682.57 / $17,413.80 / $28,297.42	Professional		$12,682.57	$17,413.80	$28,297.42