Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $4,410.00 / $8,402.10 / $27,721.90	Facility		$4,410.00	$8,402.10	$27,721.90
Aetna Facility/Professional Professional Modifier Low / Median / High Price $2,000.00 / $2,000.00 / $8,015.20	Professional		$2,000.00	$2,000.00	$8,015.20
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $5,282.76 / $8,049.92 / $20,785.90	Facility		$5,282.76	$8,049.92	$20,785.90
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $4,528.08 / $10,287.64 / $37,734.00	Professional		$4,528.08	$10,287.64	$37,734.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $5,232.45 / $8,110.29 / $12,991.19	Facility		$5,232.45	$8,110.29	$12,991.19
Cigna Facility/Professional Professional Modifier Low / Median / High Price $5,086.39 / $5,854.30 / $7,120.96	Professional		$5,086.39	$5,854.30	$7,120.96
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $5,031.20 / $6,224.91 / $15,562.28	Facility		$5,031.20	$6,224.91	$15,562.28
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $5,031.20 / $7,395.86 / $15,562.28	Professional		$5,031.20	$7,395.86	$15,562.28
Molina Facility/Professional Professional Modifier Low / Median / High Price $75.00 / $4,925.54 / $5,338.96	Professional		$75.00	$4,925.54	$5,338.96
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $5,031.20 / $5,031.20 / $7,546.80	Facility		$5,031.20	$5,031.20	$7,546.80
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $5,031.20 / $8,804.60 / $15,093.60	Facility		$5,031.20	$8,804.60	$15,093.60
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $4,528.08 / $6,289.00 / $7,597.11	Professional		$4,528.08	$6,289.00	$7,597.11
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $5,282.76 / $8,049.92 / $13,835.80	Facility		$5,282.76	$8,049.92	$13,835.80
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $5,564.51 / $9,790.69 / $11,698.24	Professional		$5,564.51	$9,790.69	$11,698.24
United Facility/Professional Professional Modifier Low / Median / High Price $2,113.10 / $2,113.10 / $5,634.94	Professional		$2,113.10	$2,113.10	$5,634.94