Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,723.64 / $6,470.00 / $22,024.00	Facility		$1,723.64	$6,470.00	$22,024.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,013.37 / $1,723.64 / $2,984.45	Professional		$1,013.37	$1,723.64	$2,984.45
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $1,552.89 / $10,956.90 / $24,231.69	Facility		$1,552.89	$10,956.90	$24,231.69
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $1,598.42 / $2,668.66 / $9,651.75	Professional		$1,598.42	$2,668.66	$9,651.75
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,395.00 / $1,917.74 / $3,438.45	Facility		$1,395.00	$1,917.74	$3,438.45
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,395.00 / $1,917.74 / $3,296.60	Professional		$1,395.00	$1,917.74	$3,296.60
Molina Facility/Professional Professional Modifier Low / Median / High Price $139.21 / $775.60 / $2,240.57	Professional		$139.21	$775.60	$2,240.57
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,652.28 / $2,185.54 / $2,306.14	Facility		$1,652.28	$2,185.54	$2,306.14
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,462.03 / $1,501.24 / $1,552.89	Facility		$1,462.03	$1,501.24	$1,552.89
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,598.42 / $2,559.67 / $3,082.33	Professional		$1,598.42	$2,559.67	$3,082.33
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $7,995.08 / $10,950.64 / $20,959.32	Facility		$7,995.08	$10,950.64	$20,959.32
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $1,531.07 / $2,233.85 / $2,914.90	Professional		$1,531.07	$2,233.85	$2,914.90
United Facility/Professional Facility Modifier Low / Median / High Price $1,750.00 / $2,937.00 / $11,941.00	Facility		$1,750.00	$2,937.00	$11,941.00
United Facility/Professional Professional Modifier Low / Median / High Price $1,365.84 / $1,821.11 / $3,121.91	Professional		$1,365.84	$1,821.11	$3,121.91