Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,227.24 / $2,013.29 / $29,742.40	Facility		$1,227.24	$2,013.29	$29,742.40
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,380.34 / $3,843.07 / $30,984.70	Professional		$1,380.34	$3,843.07	$30,984.70
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $5,434.87 / $46,708.63 / $95,056.24	Facility		$5,434.87	$46,708.63	$95,056.24
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $1,221.69 / $16,408.27 / $64,091.60	Professional		$1,221.69	$16,408.27	$64,091.60
Asuris Northwest Health Facility/Professional Professional Modifier 80 Low / Median / High Price $204.66 / $204.66 / $3,504.25	Professional	80	$204.66	$204.66	$3,504.25
Asuris Northwest Health Facility/Professional Professional Modifier AS Low / Median / High Price $173.96 / $173.96 / $3,066.22	Professional	AS	$173.96	$173.96	$3,066.22
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,110.71 / $15,778.06 / $29,292.16	Facility		$1,110.71	$15,778.06	$29,292.16
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,088.16 / $13,062.18 / $28,725.83	Professional		$1,088.16	$13,062.18	$28,725.83
Molina Facility/Professional Professional Modifier Low / Median / High Price $2,161.43 / $13,213.69 / $22,051.44	Professional		$2,161.43	$13,213.69	$22,051.44
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,492.81 / $16,432.22 / $21,584.05	Facility		$1,492.81	$16,432.22	$21,584.05
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $11,936.38 / $11,936.38 / $12,656.37	Facility		$11,936.38	$11,936.38	$12,656.37
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,158.02 / $2,240.48 / $21,879.89	Professional		$1,158.02	$2,240.48	$21,879.89
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $32,582.47 / $49,692.55 / $95,056.24	Facility		$32,582.47	$49,692.55	$95,056.24
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $1,126.25 / $2,068.40 / $20,216.11	Professional		$1,126.25	$2,068.40	$20,216.11
United Facility/Professional Professional Modifier Low / Median / High Price $13,530.29 / $18,939.72 / $28,639.08	Professional		$13,530.29	$18,939.72	$28,639.08