Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,733.00 / $5,116.62 / $18,800.00	Facility		$1,733.00	$5,116.62	$18,800.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,029.04 / $1,326.18 / $2,644.63	Professional		$1,029.04	$1,326.18	$2,644.63
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $8,562.96 / $14,663.54 / $28,049.69	Facility		$8,562.96	$14,663.54	$28,049.69
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $1,435.66 / $2,467.59 / $8,572.95	Professional		$1,435.66	$2,467.59	$8,572.95
Cigna Facility/Professional Facility Modifier Low / Median / High Price $3,585.08 / $3,585.08 / $5,972.71	Facility		$3,585.08	$3,585.08	$5,972.71
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,263.93 / $2,061.62 / $3,036.04	Professional		$1,263.93	$2,061.62	$3,036.04
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,243.91 / $2,310.55 / $9,036.82	Facility		$1,243.91	$2,310.55	$9,036.82
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,243.91 / $2,243.09 / $4,024.14	Professional		$1,243.91	$2,243.09	$4,024.14
Molina Facility/Professional Professional Modifier Low / Median / High Price $150.54 / $1,215.28 / $2,325.76	Professional		$150.54	$1,215.28	$2,325.76
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,552.90 / $1,957.74 / $2,016.70	Facility		$1,552.90	$1,957.74	$2,016.70
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,337.71 / $1,375.57 / $2,173.03	Facility		$1,337.71	$1,375.57	$2,173.03
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,415.90 / $2,294.52 / $2,821.27	Professional		$1,415.90	$2,294.52	$2,821.27
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $9,508.65 / $14,655.16 / $28,049.69	Facility		$9,508.65	$14,655.16	$28,049.69
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $1,364.29 / $1,977.34 / $2,665.36	Professional		$1,364.29	$1,977.34	$2,665.36
United Facility/Professional Facility Modifier Low / Median / High Price $2,155.00 / $3,297.00 / $12,835.00	Facility		$2,155.00	$3,297.00	$12,835.00
United Facility/Professional Professional Modifier Low / Median / High Price $1,256.46 / $1,957.74 / $2,870.44	Professional		$1,256.46	$1,957.74	$2,870.44