Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,994.05 / $6,470.00 / $22,024.00	Facility		$1,994.05	$6,470.00	$22,024.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,128.01 / $1,994.05 / $3,801.74	Professional		$1,128.01	$1,994.05	$3,801.74
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $2,807.45 / $14,811.42 / $28,332.57	Facility		$2,807.45	$14,811.42	$28,332.57
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $1,896.13 / $3,169.12 / $11,166.45	Professional		$1,896.13	$3,169.12	$11,166.45
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,600.50 / $3,240.25 / $7,372.04	Facility		$1,600.50	$3,240.25	$7,372.04
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,600.50 / $3,064.58 / $6,233.81	Professional		$1,600.50	$3,064.58	$6,233.81
Molina Facility/Professional Professional Modifier Low / Median / High Price $157.37 / $769.24 / $2,585.95	Professional		$157.37	$769.24	$2,585.95
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,850.73 / $2,526.57 / $2,635.11	Facility		$1,850.73	$2,526.57	$2,635.11
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,738.61 / $1,738.61 / $1,797.38	Facility		$1,738.61	$1,738.61	$1,797.38
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,850.08 / $2,963.71 / $3,567.62	Professional		$1,850.08	$2,963.71	$3,567.62
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $9,567.02 / $14,482.75 / $28,332.57	Facility		$9,567.02	$14,482.75	$28,332.57
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $1,773.16 / $2,585.56 / $3,405.98	Professional		$1,773.16	$2,585.56	$3,405.98
United Facility/Professional Facility Modifier Low / Median / High Price $2,263.00 / $4,403.67 / $10,312.00	Facility		$2,263.00	$4,403.67	$10,312.00
United Facility/Professional Professional Modifier Low / Median / High Price $1,582.15 / $2,034.19 / $3,729.34	Professional		$1,582.15	$2,034.19	$3,729.34