Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,675.07 / $5,128.00 / $20,680.40	Facility		$1,675.07	$5,128.00	$20,680.40
Aetna Facility/Professional Professional Modifier Low / Median / High Price $796.30 / $1,067.47 / $2,445.88	Professional		$796.30	$1,067.47	$2,445.88
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $55.00 / $1,253.08 / $10,042.62	Facility		$55.00	$1,253.08	$10,042.62
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $1,318.32 / $2,265.90 / $7,911.75	Professional		$1,318.32	$2,265.90	$7,911.75
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,088.30 / $1,884.88 / $2,754.46	Professional		$1,088.30	$1,884.88	$2,754.46
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,071.18 / $1,829.90 / $2,230.10	Facility		$1,071.18	$1,829.90	$2,230.10
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,071.18 / $1,829.90 / $2,316.10	Professional		$1,071.18	$1,829.90	$2,316.10
Molina Facility/Professional Professional Modifier Low / Median / High Price $148.90 / $1,036.42 / $2,058.82	Professional		$148.90	$1,036.42	$2,058.82
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,329.95 / $1,762.35 / $1,839.15	Facility		$1,329.95	$1,762.35	$1,839.15
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,229.44 / $1,253.08 / $1,367.95	Facility		$1,229.44	$1,253.08	$1,367.95
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,318.32 / $2,090.23 / $2,570.08	Professional		$1,318.32	$2,090.23	$2,570.08
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $11,183.62 / $11,183.62 / $21,189.66	Facility		$11,183.62	$11,183.62	$21,189.66
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $1,253.86 / $1,802.59 / $2,428.04	Professional		$1,253.86	$1,802.59	$2,428.04
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 $1,159.18 / $1,786.24 / $2,635.81	Professional		$1,159.18	$1,786.24	$2,635.81