Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,560.00 / $12,757.68 / $27,982.24	Facility		$1,560.00	$12,757.68	$27,982.24
Aetna Facility/Professional Professional Modifier Low / Median / High Price $803.56 / $1,321.96 / $2,442.94	Professional		$803.56	$1,321.96	$2,442.94
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $9,892.57 / $16,197.56 / $30,984.11	Facility		$9,892.57	$16,197.56	$30,984.11
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $1,758.83 / $3,367.72 / $13,880.18	Professional		$1,758.83	$3,367.72	$13,880.18
Cigna Facility/Professional Facility Modifier Low / Median / High Price $9,327.76 / $9,327.76 / $9,327.76	Facility		$9,327.76	$9,327.76	$9,327.76
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $5,061.89 / $18,092.47 / $45,355.09	Facility		$5,061.89	$18,092.47	$45,355.09
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $4,865.45 / $4,865.45 / $4,865.45	Professional		$4,865.45	$4,865.45	$4,865.45
Molina Facility/Professional Professional Modifier Low / Median / High Price $49.50 / $49.50 / $49.50	Professional		$49.50	$49.50	$49.50
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,634.64 / $3,934.94 / $6,609.35	Facility		$1,634.64	$3,934.94	$6,609.35
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,893.09 / $1,893.09 / $2,173.48	Facility		$1,893.09	$1,893.09	$2,173.48
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $2,173.48 / $3,291.80 / $4,314.17	Professional		$2,173.48	$3,291.80	$4,314.17
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $11,819.11 / $16,197.56 / $30,984.11	Facility		$11,819.11	$16,197.56	$30,984.11
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $1,758.83 / $3,051.45 / $4,211.43	Professional		$1,758.83	$3,051.45	$4,211.43
United Facility/Professional Facility Modifier Low / Median / High Price $3,028.00 / $11,540.00 / $20,708.00	Facility		$3,028.00	$11,540.00	$20,708.00
United Facility/Professional Professional Modifier Low / Median / High Price $1,675.08 / $2,550.69 / $5,414.61	Professional		$1,675.08	$2,550.69	$5,414.61