Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,399.55 / $5,003.78 / $20,680.40	Facility		$2,399.55	$5,003.78	$20,680.40
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,611.23 / $2,399.55 / $5,003.78	Professional		$1,611.23	$2,399.55	$5,003.78
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $55.00 / $2,647.33 / $27,163.56	Facility		$55.00	$2,647.33	$27,163.56
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $2,813.93 / $4,908.60 / $18,143.40	Professional		$2,813.93	$4,908.60	$18,143.40
Cigna Facility/Professional Professional Modifier Low / Median / High Price $2,443.94 / $4,001.62 / $5,884.56	Professional		$2,443.94	$4,001.62	$5,884.56
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,894.61 / $3,766.07 / $4,917.76	Facility		$1,894.61	$3,766.07	$4,917.76
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $2,104.86 / $3,810.38 / $4,988.91	Professional		$2,104.86	$3,810.38	$4,988.91
Molina Facility/Professional Professional Modifier Low / Median / High Price $200.71 / $728.37 / $4,188.15	Professional		$200.71	$728.37	$4,188.15
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $2,638.87 / $3,479.05 / $4,007.94	Facility		$2,638.87	$3,479.05	$4,007.94
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,647.33 / $2,647.33 / $2,733.77	Facility		$2,647.33	$2,647.33	$2,733.77
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $2,813.93 / $4,549.28 / $5,606.93	Professional		$2,813.93	$4,549.28	$5,606.93
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $2,699.93 / $3,932.56 / $5,297.06	Professional		$2,699.93	$3,932.56	$5,297.06
United Facility/Professional Facility Modifier Low / Median / High Price $703.00 / $2,446.00 / $36,803.00	Facility		$703.00	$2,446.00	$36,803.00
United Facility/Professional Professional Modifier Low / Median / High Price $2,384.34 / $3,882.63 / $5,729.29	Professional		$2,384.34	$3,882.63	$5,729.29