Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,044.15 / $6,470.00 / $22,024.00	Facility		$2,044.15	$6,470.00	$22,024.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,041.80 / $2,044.15 / $3,748.03	Professional		$1,041.80	$2,044.15	$3,748.03
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $1,832.57 / $10,956.90 / $24,231.69	Facility		$1,832.57	$10,956.90	$24,231.69
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $1,886.30 / $3,357.20 / $11,443.20	Professional		$1,886.30	$3,357.20	$11,443.20
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,031.00 / $1,031.00 / $4,764.52	Facility		$1,031.00	$1,031.00	$4,764.52
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,241.65 / $2,085.01 / $4,213.97	Professional		$1,241.65	$2,085.01	$4,213.97
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,455.50 / $2,362.28 / $4,250.62	Facility		$1,455.50	$2,362.28	$4,250.62
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,455.50 / $2,362.28 / $4,178.32	Professional		$1,455.50	$2,362.28	$4,178.32
Molina Facility/Professional Professional Modifier Low / Median / High Price $118.19 / $765.55 / $2,637.65	Professional		$118.19	$765.55	$2,637.65
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,669.43 / $2,335.62 / $2,686.70	Facility		$1,669.43	$2,335.62	$2,686.70
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,504.82 / $1,802.49 / $1,832.57	Facility		$1,504.82	$1,802.49	$1,832.57
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,890.03 / $3,037.56 / $3,642.80	Professional		$1,890.03	$3,037.56	$3,642.80
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 $1,838.30 / $2,636.17 / $3,472.66	Professional		$1,838.30	$2,636.17	$3,472.66
United Facility/Professional Facility Modifier Low / Median / High Price $1,620.00 / $3,218.44 / $7,198.00	Facility		$1,620.00	$3,218.44	$7,198.00
United Facility/Professional Professional Modifier Low / Median / High Price $1,462.44 / $2,024.40 / $3,578.85	Professional		$1,462.44	$2,024.40	$3,578.85