Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,197.21 / $4,500.00 / $20,680.40	Facility		$2,197.21	$4,500.00	$20,680.40
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,564.58 / $2,197.21 / $4,487.64	Professional		$1,564.58	$2,197.21	$4,487.64
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $1,140.42 / $9,124.02 / $20,178.18	Facility		$1,140.42	$9,124.02	$20,178.18
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $2,500.69 / $4,498.60 / $16,582.80	Professional		$2,500.69	$4,498.60	$16,582.80
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,982.56 / $1,982.56 / $3,302.92	Facility		$1,982.56	$1,982.56	$3,302.92
Cigna Facility/Professional Professional Modifier Low / Median / High Price $2,236.69 / $3,610.66 / $5,390.77	Professional		$2,236.69	$3,610.66	$5,390.77
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $2,088.06 / $3,410.69 / $8,266.54	Facility		$2,088.06	$3,410.69	$8,266.54
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $2,088.06 / $3,417.70 / $4,565.39	Professional		$2,088.06	$3,417.70	$4,565.39
Molina Facility/Professional Professional Modifier Low / Median / High Price $190.97 / $608.90 / $3,833.09	Professional		$190.97	$608.90	$3,833.09
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $2,497.11 / $3,415.04 / $3,666.24	Facility		$2,497.11	$3,415.04	$3,666.24
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,140.42 / $2,416.76 / $2,500.69	Facility		$1,140.42	$2,416.76	$2,500.69
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $2,617.32 / $4,151.34 / $5,128.91	Professional		$2,617.32	$4,151.34	$5,128.91
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $6,812.14 / $9,118.81 / $17,453.22	Facility		$6,812.14	$9,118.81	$17,453.22
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $2,464.77 / $3,597.29 / $4,845.46	Professional		$2,464.77	$3,597.29	$4,845.46
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 $2,173.92 / $3,821.66 / $5,233.02	Professional		$2,173.92	$3,821.66	$5,233.02