Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,267.48 / $10,596.56 / $22,024.00	Facility		$2,267.48	$10,596.56	$22,024.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,631.46 / $2,267.48 / $2,639.20	Professional		$1,631.46	$2,267.48	$2,639.20
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $5,351.36 / $10,802.03 / $20,897.68	Facility		$5,351.36	$10,802.03	$20,897.68
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $2,790.98 / $4,768.53 / $17,554.43	Professional		$2,790.98	$4,768.53	$17,554.43
Cigna Facility/Professional Professional Modifier Low / Median / High Price $2,846.42 / $2,846.42 / $2,846.42	Professional		$2,846.42	$2,846.42	$2,846.42
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $3,309.96 / $4,789.14 / $13,073.95	Facility		$3,309.96	$4,789.14	$13,073.95
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $3,309.96 / $4,591.56 / $6,299.19	Professional		$3,309.96	$4,591.56	$6,299.19
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 $1,215.68 / $2,002.24 / $4,030.05	Facility		$1,215.68	$2,002.24	$4,030.05
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,722.53 / $2,722.53 / $2,748.86	Facility		$2,722.53	$2,722.53	$2,748.86
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $2,933.37 / $4,585.22 / $5,637.86	Professional		$2,933.37	$4,585.22	$5,637.86
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $7,882.07 / $10,802.03 / $20,663.07	Facility		$7,882.07	$10,802.03	$20,663.07
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $2,776.62 / $3,760.53 / $5,038.89	Professional		$2,776.62	$3,760.53	$5,038.89
United Facility/Professional Facility Modifier Low / Median / High Price $1,550.00 / $2,431.00 / $11,261.00	Facility		$1,550.00	$2,431.00	$11,261.00
United Facility/Professional Professional Modifier Low / Median / High Price $3,262.16 / $5,510.03 / $7,365.28	Professional		$3,262.16	$5,510.03	$7,365.28