Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,648.40 / $3,412.10 / $20,680.40	Facility		$1,648.40	$3,412.10	$20,680.40
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,207.05 / $1,648.40 / $3,412.10	Professional		$1,207.05	$1,648.40	$3,412.10
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $55.00 / $1,764.89 / $23,844.32	Facility		$55.00	$1,764.89	$23,844.32
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $1,825.15 / $3,078.00 / $18,481.68	Professional		$1,825.15	$3,078.00	$18,481.68
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,674.90 / $2,592.85 / $3,839.92	Professional		$1,674.90	$2,592.85	$3,839.92
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,251.16 / $2,786.17 / $3,383.76	Facility		$1,251.16	$2,786.17	$3,383.76
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,630.96 / $2,815.03 / $3,616.34	Professional		$1,630.96	$2,815.03	$3,616.34
Molina Facility/Professional Professional Modifier Low / Median / High Price $323.30 / $2,000.08 / $3,253.64	Professional		$323.30	$2,000.08	$3,253.64
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,937.64 / $2,468.19 / $2,639.76	Facility		$1,937.64	$2,468.19	$2,639.76
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,764.89 / $1,764.89 / $1,773.16	Facility		$1,764.89	$1,764.89	$1,773.16
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,873.65 / $2,952.29 / $3,533.52	Professional		$1,873.65	$2,952.29	$3,533.52
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $1,799.95 / $2,550.71 / $3,435.74	Professional		$1,799.95	$2,550.71	$3,435.74
United Facility/Professional Facility Modifier Low / Median / High Price $1,120.00 / $3,323.00 / $36,803.00	Facility		$1,120.00	$3,323.00	$36,803.00
United Facility/Professional Professional Modifier Low / Median / High Price $1,691.94 / $2,313.59 / $3,746.13	Professional		$1,691.94	$2,313.59	$3,746.13