Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,733.00 / $10,180.24 / $20,680.40	Facility		$1,733.00	$10,180.24	$20,680.40
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,072.81 / $1,358.98 / $2,773.20	Professional		$1,072.81	$1,358.98	$2,773.20
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $1,496.26 / $11,266.46 / $22,040.55	Facility		$1,496.26	$11,266.46	$22,040.55
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $1,545.12 / $2,625.35 / $9,602.35	Professional		$1,545.12	$2,625.35	$9,602.35
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,925.00 / $1,925.00 / $4,960.67	Facility		$1,925.00	$1,925.00	$4,960.67
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,146.07 / $1,833.59 / $3,481.28	Professional		$1,146.07	$1,833.59	$3,481.28
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,556.96 / $2,459.53 / $4,350.34	Facility		$1,556.96	$2,459.53	$4,350.34
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,556.96 / $2,459.53 / $3,678.65	Professional		$1,556.96	$2,459.53	$3,678.65
Molina Facility/Professional Professional Modifier Low / Median / High Price $141.32 / $754.32 / $2,212.70	Professional		$141.32	$754.32	$2,212.70
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,847.30 / $2,188.21 / $2,586.92	Facility		$1,847.30	$2,188.21	$2,586.92
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,496.26 / $1,496.26 / $1,793.08	Facility		$1,496.26	$1,496.26	$1,793.08
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,590.42 / $2,551.30 / $3,066.91	Professional		$1,590.42	$2,551.30	$3,066.91
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $8,407.53 / $11,522.14 / $22,040.55	Facility		$8,407.53	$11,522.14	$22,040.55
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $1,525.99 / $2,222.67 / $2,927.95	Professional		$1,525.99	$2,222.67	$2,927.95
United Facility/Professional Facility Modifier Low / Median / High Price $2,263.00 / $2,912.00 / $16,315.00	Facility		$2,263.00	$2,912.00	$16,315.00
United Facility/Professional Professional Modifier Low / Median / High Price $1,399.23 / $1,771.47 / $3,098.75	Professional		$1,399.23	$1,771.47	$3,098.75