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 $1,144.52 / $1,533.41 / $3,351.42	Professional		$1,144.52	$1,533.41	$3,351.42
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $1,768.06 / $20,128.48 / $40,963.26	Facility		$1,768.06	$20,128.48	$40,963.26
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $1,854.32 / $3,119.26 / $11,369.55	Professional		$1,854.32	$3,119.26	$11,369.55
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,586.07 / $2,710.15 / $3,953.69	Professional		$1,586.07	$2,710.15	$3,953.69
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,631.28 / $2,946.26 / $11,411.87	Facility		$1,631.28	$2,946.26	$11,411.87
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,631.28 / $2,763.48 / $3,990.41	Professional		$1,631.28	$2,763.48	$3,990.41
Molina Facility/Professional Professional Modifier Low / Median / High Price $141.12 / $498.61 / $2,737.00	Professional		$141.12	$498.61	$2,737.00
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,919.33 / $2,490.39 / $2,654.04	Facility		$1,919.33	$2,490.39	$2,654.04
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,768.06 / $1,768.06 / $1,801.49	Facility		$1,768.06	$1,768.06	$1,801.49
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,879.02 / $3,004.99 / $3,694.84	Professional		$1,879.02	$3,004.99	$3,694.84
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 $1,803.19 / $2,591.46 / $3,490.64	Professional		$1,803.19	$2,591.46	$3,490.64
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 $1,681.24 / $2,772.45 / $3,796.33	Professional		$1,681.24	$2,772.45	$3,796.33