Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,090.40 / $2,661.56 / $6,391.60	Facility		$1,090.40	$2,661.56	$6,391.60
Aetna Facility/Professional Professional Modifier Low / Median / High Price $614.79 / $1,090.40 / $1,716.80	Professional		$614.79	$1,090.40	$1,716.80
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $1,218.00 / $1,856.00 / $4,792.42	Facility		$1,218.00	$1,856.00	$4,792.42
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $1,090.40 / $2,376.23 / $8,700.00	Professional		$1,090.40	$2,376.23	$8,700.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $616.96 / $1,885.00 / $2,995.27	Facility		$616.96	$1,885.00	$2,995.27
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,191.28 / $1,334.00 / $1,582.72	Professional		$1,191.28	$1,334.00	$1,582.72
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,160.00 / $1,450.00 / $3,970.31	Facility		$1,160.00	$1,450.00	$3,970.31
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,160.00 / $1,705.20 / $3,588.10	Professional		$1,160.00	$1,705.20	$3,588.10
Molina Facility/Professional Professional Modifier Low / Median / High Price $75.00 / $75.00 / $75.00	Professional		$75.00	$75.00	$75.00
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,160.00 / $1,160.00 / $1,740.00	Facility		$1,160.00	$1,160.00	$1,740.00
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,160.00 / $2,030.00 / $3,480.00	Facility		$1,160.00	$2,030.00	$3,480.00
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,044.00 / $1,450.00 / $1,751.60	Professional		$1,044.00	$1,450.00	$1,751.60
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $1,218.00 / $1,856.00 / $3,190.00	Facility		$1,218.00	$1,856.00	$3,190.00
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $1,282.96 / $2,257.42 / $2,697.39	Professional		$1,282.96	$2,257.42	$2,697.39
United Facility/Professional Facility Modifier Low / Median / High Price $1,160.00 / $1,392.00 / $1,392.00	Facility		$1,160.00	$1,392.00	$1,392.00
United Facility/Professional Professional Modifier Low / Median / High Price $487.20 / $487.20 / $1,299.20	Professional		$487.20	$487.20	$1,299.20