Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,776.86 / $5,128.00 / $20,680.40	Facility		$1,776.86	$5,128.00	$20,680.40
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,031.32 / $1,776.86 / $3,425.73	Professional		$1,031.32	$1,776.86	$3,425.73
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $5,308.60 / $9,475.57 / $23,606.56	Facility		$5,308.60	$9,475.57	$23,606.56
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $1,769.64 / $3,127.44 / $10,832.55	Professional		$1,769.64	$3,127.44	$10,832.55
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,982.56 / $1,982.56 / $3,302.92	Facility		$1,982.56	$1,982.56	$3,302.92
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,584.73 / $2,633.44 / $3,845.44	Professional		$1,584.73	$2,633.44	$3,845.44
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,558.82 / $2,662.92 / $6,447.65	Facility		$1,558.82	$2,662.92	$6,447.65
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,585.08 / $2,561.91 / $3,562.58	Professional		$1,585.08	$2,561.91	$3,562.58
Molina Facility/Professional Professional Modifier Low / Median / High Price $138.48 / $455.19 / $2,730.20	Professional		$138.48	$455.19	$2,730.20
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,807.67 / $2,420.71 / $2,539.80	Facility		$1,807.67	$2,420.71	$2,539.80
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,140.42 / $1,691.96 / $1,719.23	Facility		$1,140.42	$1,691.96	$1,719.23
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,807.80 / $2,867.77 / $3,526.12	Professional		$1,807.80	$2,867.77	$3,526.12
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $5,916.52 / $9,101.25 / $17,453.22	Facility		$5,916.52	$9,101.25	$17,453.22
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $1,725.57 / $2,473.14 / $3,331.25	Professional		$1,725.57	$2,473.14	$3,331.25
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 $1,588.50 / $2,465.41 / $3,638.01	Professional		$1,588.50	$2,465.41	$3,638.01