Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $570.66 / $934.52 / $3,892.43	Facility		$570.66	$934.52	$3,892.43
Aetna Facility/Professional Professional Modifier Low / Median / High Price $640.72 / $1,766.42 / $4,107.06	Professional		$640.72	$1,766.42	$4,107.06
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $55.00 / $1,417.16 / $1,896.17	Facility		$55.00	$1,417.16	$1,896.17
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $567.50 / $1,978.44 / $7,603.36	Professional		$567.50	$1,978.44	$7,603.36
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $503.44 / $1,268.21 / $3,602.12	Facility		$503.44	$1,268.21	$3,602.12
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $506.14 / $1,268.21 / $3,590.12	Professional		$506.14	$1,268.21	$3,590.12
Molina Facility/Professional Professional Modifier Low / Median / High Price $266.87 / $1,631.47 / $2,704.49	Professional		$266.87	$1,631.47	$2,704.49
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $650.57 / $2,016.18 / $2,743.14	Facility		$650.57	$2,016.18	$2,743.14
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,417.16 / $1,417.16 / $1,441.90	Facility		$1,417.16	$1,417.16	$1,441.90
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $537.91 / $1,040.74 / $2,597.71	Professional		$537.91	$1,040.74	$2,597.71
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $19,998.99 / $19,998.99 / $25,195.67	Facility		$19,998.99	$19,998.99	$25,195.67
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $514.10 / $960.80 / $2,400.17	Professional		$514.10	$960.80	$2,400.17
United Facility/Professional Professional Modifier Low / Median / High Price $1,499.40 / $2,263.67 / $3,246.81	Professional		$1,499.40	$2,263.67	$3,246.81