Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,586.52 / $5,611.67 / $20,680.40	Facility		$2,586.52	$5,611.67	$20,680.40
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,808.18 / $2,586.52 / $5,111.18	Professional		$1,808.18	$2,586.52	$5,111.18
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $2,651.41 / $16,595.73 / $31,745.76	Facility		$2,651.41	$16,595.73	$31,745.76
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $2,796.03 / $4,904.47 / $16,975.28	Professional		$2,796.03	$4,904.47	$16,975.28
Cigna Facility/Professional Professional Modifier Low / Median / High Price $2,407.34 / $4,111.13 / $5,997.37	Professional		$2,407.34	$4,111.13	$5,997.37
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $2,474.64 / $4,128.66 / $11,234.92	Facility		$2,474.64	$4,128.66	$11,234.92
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $2,474.64 / $4,010.29 / $5,357.78	Professional		$2,474.64	$4,010.29	$5,357.78
Molina Facility/Professional Professional Modifier Low / Median / High Price $146.40 / $751.21 / $4,243.30	Professional		$146.40	$751.21	$4,243.30
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $2,868.27 / $3,764.06 / $3,980.04	Facility		$2,868.27	$3,764.06	$3,980.04
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,651.41 / $2,651.41 / $2,699.04	Facility		$2,651.41	$2,651.41	$2,699.04
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $2,843.62 / $4,502.14 / $5,535.69	Professional		$2,843.62	$4,502.14	$5,535.69
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $10,761.59 / $16,586.25 / $31,745.76	Facility		$10,761.59	$16,586.25	$31,745.76
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $2,704.09 / $3,882.60 / $5,229.76	Professional		$2,704.09	$3,882.60	$5,229.76
United Facility/Professional Facility Modifier Low / Median / High Price $2,912.00 / $3,509.00 / $17,644.00	Facility		$2,912.00	$3,509.00	$17,644.00
United Facility/Professional Professional Modifier Low / Median / High Price $2,471.92 / $3,932.60 / $5,705.13	Professional		$2,471.92	$3,932.60	$5,705.13