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 $1,028.80 / $1,380.36 / $3,210.68	Professional		$1,028.80	$1,380.36	$3,210.68
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $1,590.48 / $13,249.10 / $26,963.11	Facility		$1,590.48	$13,249.10	$26,963.11
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $1,668.51 / $2,934.05 / $10,235.18	Professional		$1,668.51	$2,934.05	$10,235.18
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,397.71 / $2,441.33 / $3,564.72	Professional		$1,397.71	$2,441.33	$3,564.72
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,469.58 / $2,598.32 / $7,931.04	Facility		$1,469.58	$2,598.32	$7,931.04
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,469.58 / $2,398.34 / $3,563.43	Professional		$1,469.58	$2,398.34	$3,563.43
Molina Facility/Professional Professional Modifier Low / Median / High Price $122.71 / $446.29 / $2,473.30	Professional		$122.71	$446.29	$2,473.30
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,699.65 / $2,275.32 / $2,388.55	Facility		$1,699.65	$2,275.32	$2,388.55
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,590.48 / $1,590.48 / $1,620.98	Facility		$1,590.48	$1,590.48	$1,620.98
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,816.28 / $2,703.88 / $3,324.60	Professional		$1,816.28	$2,703.88	$3,324.60
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $8,791.87 / $14,087.45 / $26,963.11	Facility		$8,791.87	$14,087.45	$26,963.11
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $1,622.08 / $2,331.79 / $3,140.87	Professional		$1,622.08	$2,331.79	$3,140.87
United Facility/Professional Facility Modifier Low / Median / High Price $1,862.00 / $4,395.58 / $10,522.00	Facility		$1,862.00	$4,395.58	$10,522.00
United Facility/Professional Professional Modifier Low / Median / High Price $1,460.28 / $2,312.94 / $3,413.04	Professional		$1,460.28	$2,312.94	$3,413.04