Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,946.79 / $10,700.00 / $22,024.00	Facility		$1,946.79	$10,700.00	$22,024.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,220.18 / $1,946.79 / $2,491.26	Professional		$1,220.18	$1,946.79	$2,491.26
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $5,650.51 / $9,032.98 / $17,279.07	Facility		$5,650.51	$9,032.98	$17,279.07
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $1,932.55 / $3,321.08 / $12,242.40	Professional		$1,932.55	$3,321.08	$12,242.40
Cigna Facility/Professional Facility Modifier Low / Median / High Price $5,033.76 / $5,033.76 / $5,033.76	Facility		$5,033.76	$5,033.76	$5,033.76
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $2,923.63 / $4,414.43 / $14,039.89	Facility		$2,923.63	$4,414.43	$14,039.89
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $2,466.65 / $3,391.53 / $6,056.21	Professional		$2,466.65	$3,391.53	$6,056.21
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 $1,911.11 / $2,730.16 / $3,908.54	Facility		$1,911.11	$2,730.16	$3,908.54
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,917.12 / $1,917.12 / $2,651.41	Facility		$1,917.12	$1,917.12	$2,651.41
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,917.12 / $2,693.15 / $3,805.28	Professional		$1,917.12	$2,693.15	$3,805.28
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $6,591.22 / $9,027.82 / $17,279.07	Facility		$6,591.22	$9,027.82	$17,279.07
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $1,932.55 / $3,111.12 / $4,293.79	Professional		$1,932.55	$3,111.12	$4,293.79
United Facility/Professional Facility Modifier Low / Median / High Price $2,155.00 / $6,594.00 / $12,835.00	Facility		$2,155.00	$6,594.00	$12,835.00
United Facility/Professional Professional Modifier Low / Median / High Price $2,333.52 / $3,055.79 / $4,843.72	Professional		$2,333.52	$3,055.79	$4,843.72