Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,733.00 / $5,128.00 / $20,680.40	Facility		$1,733.00	$5,128.00	$20,680.40
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,006.13 / $1,347.19 / $2,944.08	Professional		$1,006.13	$1,347.19	$2,944.08
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $1,552.88 / $20,128.48 / $40,963.26	Facility		$1,552.88	$20,128.48	$40,963.26
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $1,629.47 / $2,739.26 / $9,993.37	Professional		$1,629.47	$2,739.26	$9,993.37
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,390.91 / $2,381.26 / $3,475.84	Professional		$1,390.91	$2,381.26	$3,475.84
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,433.04 / $2,573.28 / $11,411.87	Facility		$1,433.04	$2,573.28	$11,411.87
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,433.04 / $2,410.32 / $3,885.58	Professional		$1,433.04	$2,410.32	$3,885.58
Molina Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $432.87 / $2,415.81	Professional		$112.20	$432.87	$2,415.81
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,660.38 / $2,189.56 / $2,331.04	Facility		$1,660.38	$2,189.56	$2,331.04
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,552.88 / $1,552.88 / $1,583.05	Facility		$1,552.88	$1,552.88	$1,583.05
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,638.58 / $2,640.61 / $3,246.81	Professional		$1,638.58	$2,640.61	$3,246.81
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $13,886.25 / $21,402.13 / $40,963.26	Facility		$13,886.25	$21,402.13	$40,963.26
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $1,583.74 / $2,277.23 / $3,067.37	Professional		$1,583.74	$2,277.23	$3,067.37
United Facility/Professional Facility Modifier Low / Median / High Price $2,912.00 / $3,509.00 / $17,644.00	Facility		$2,912.00	$3,509.00	$17,644.00
United Facility/Professional Professional Modifier Low / Median / High Price $1,464.41 / $2,306.07 / $3,333.89	Professional		$1,464.41	$2,306.07	$3,333.89