Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,772.77 / $5,689.61 / $20,680.40	Facility		$2,772.77	$5,689.61	$20,680.40
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,842.93 / $2,772.77 / $5,698.25	Professional		$1,842.93	$2,772.77	$5,698.25
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $2,908.71 / $5,897.00 / $15,086.58	Facility		$2,908.71	$5,897.00	$15,086.58
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $3,048.66 / $5,032.50 / $24,606.41	Professional		$3,048.66	$5,032.50	$24,606.41
Cigna Facility/Professional Professional Modifier Low / Median / High Price $2,720.28 / $4,474.67 / $6,520.47	Professional		$2,720.28	$4,474.67	$6,520.47
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $2,676.69 / $4,454.81 / $5,553.31	Facility		$2,676.69	$4,454.81	$5,553.31
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $2,676.69 / $4,454.81 / $5,574.04	Professional		$2,676.69	$4,454.81	$5,574.04
Molina Facility/Professional Professional Modifier Low / Median / High Price $247.19 / $993.11 / $4,420.72	Professional		$247.19	$993.11	$4,420.72
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $3,148.30 / $4,205.81 / $4,349.28	Facility		$3,148.30	$4,205.81	$4,349.28
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,908.71 / $2,908.71 / $2,961.82	Facility		$2,908.71	$2,908.71	$2,961.82
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $3,126.29 / $4,940.47 / $6,074.64	Professional		$3,126.29	$4,940.47	$6,074.64
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $2,966.50 / $4,260.60 / $5,738.93	Professional		$2,966.50	$4,260.60	$5,738.93
United Facility/Professional Facility Modifier Low / Median / High Price $2,912.00 / $3,509.00 / $17,644.00	Facility		$2,912.00	$3,509.00	$17,644.00
United Facility/Professional Professional Modifier Low / Median / High Price $2,788.23 / $4,447.80 / $6,290.45	Professional		$2,788.23	$4,447.80	$6,290.45