Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,469.82 / $3,294.00 / $20,680.40	Facility		$1,469.82	$3,294.00	$20,680.40
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,014.87 / $1,469.82 / $2,995.61	Professional		$1,014.87	$1,469.82	$2,995.61
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $55.00 / $1,523.44 / $10,711.76	Facility		$55.00	$1,523.44	$10,711.76
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $1,612.53 / $2,802.55 / $9,760.65	Professional		$1,612.53	$2,802.55	$9,760.65
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,437.11 / $2,347.96 / $3,455.28	Professional		$1,437.11	$2,347.96	$3,455.28
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,357.51 / $2,416.42 / $2,934.70	Facility		$1,357.51	$2,416.42	$2,934.70
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,414.52 / $2,416.42 / $2,934.70	Professional		$1,414.52	$2,416.42	$2,934.70
Molina Facility/Professional Professional Modifier Low / Median / High Price $150.40 / $1,408.57 / $2,697.51	Professional		$150.40	$1,408.57	$2,697.51
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,653.46 / $2,221.05 / $2,296.76	Facility		$1,653.46	$2,221.05	$2,296.76
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,523.44 / $1,523.44 / $1,566.60	Facility		$1,523.44	$1,523.44	$1,566.60
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,612.53 / $2,613.16 / $3,213.06	Professional		$1,612.53	$2,613.16	$3,213.06
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $1,553.71 / $2,253.36 / $3,035.49	Professional		$1,553.71	$2,253.36	$3,035.49
United Facility/Professional Facility Modifier Low / Median / High Price $703.00 / $2,446.00 / $36,803.00	Facility		$703.00	$2,446.00	$36,803.00
United Facility/Professional Professional Modifier Low / Median / High Price $1,465.64 / $2,388.89 / $3,271.12	Professional		$1,465.64	$2,388.89	$3,271.12