Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,507.37 / $5,128.00 / $20,680.40	Facility		$1,507.37	$5,128.00	$20,680.40
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,187.95 / $1,507.37 / $3,180.83	Professional		$1,187.95	$1,507.37	$3,180.83
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $1,644.39 / $14,638.06 / $29,789.77	Facility		$1,644.39	$14,638.06	$29,789.77
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $1,677.06 / $2,781.65 / $12,431.63	Professional		$1,677.06	$2,781.65	$12,431.63
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,532.13 / $2,401.12 / $3,569.58	Professional		$1,532.13	$2,401.12	$3,569.58
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,705.39 / $2,763.87 / $10,488.49	Facility		$1,705.39	$2,763.87	$10,488.49
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,705.39 / $2,629.96 / $3,480.00	Professional		$1,705.39	$2,629.96	$3,480.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $103.23 / $1,064.91 / $2,657.21	Professional		$103.23	$1,064.91	$2,657.21
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,947.75 / $2,305.50 / $2,478.33	Facility		$1,947.75	$2,305.50	$2,478.33
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,644.39 / $1,644.39 / $1,658.45	Facility		$1,644.39	$1,644.39	$1,658.45
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,744.72 / $2,749.13 / $3,291.87	Professional		$1,744.72	$2,749.13	$3,291.87
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $10,098.52 / $15,564.30 / $29,789.77	Facility		$10,098.52	$15,564.30	$29,789.77
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $1,677.06 / $2,385.71 / $3,213.48	Professional		$1,677.06	$2,385.71	$3,213.48
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 $1,548.86 / $2,363.98 / $3,511.96	Professional		$1,548.86	$2,363.98	$3,511.96