Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $89.29 / $4,317.22 / $14,931.80	Facility		$89.29	$4,317.22	$14,931.80
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,355.00 / $2,710.00 / $4,317.22	Professional		$1,355.00	$2,710.00	$4,317.22
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $2,845.45 / $4,335.92 / $11,195.89	Facility		$2,845.45	$4,335.92	$11,195.89
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $2,438.96 / $5,294.81 / $20,324.63	Professional		$2,438.96	$5,294.81	$20,324.63
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,710.00 / $4,368.45 / $6,997.44	Facility		$2,710.00	$4,368.45	$6,997.44
Cigna Facility/Professional Professional Modifier Low / Median / High Price $2,739.59 / $3,153.28 / $3,835.42	Professional		$2,739.59	$3,153.28	$3,835.42
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $2,709.95 / $3,353.07 / $8,382.68	Facility		$2,709.95	$3,353.07	$8,382.68
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $2,709.95 / $3,983.63 / $8,382.68	Professional		$2,709.95	$3,983.63	$8,382.68
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 $2,709.95 / $2,709.95 / $4,064.93	Facility		$2,709.95	$2,709.95	$4,064.93
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,709.95 / $4,742.41 / $8,129.85	Facility		$2,709.95	$4,742.41	$8,129.85
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $2,438.96 / $3,387.44 / $4,092.02	Professional		$2,438.96	$3,387.44	$4,092.02
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $2,845.45 / $4,335.92 / $7,452.36	Facility		$2,845.45	$4,335.92	$7,452.36
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $2,997.20 / $5,273.83 / $6,301.13	Professional		$2,997.20	$5,273.83	$6,301.13
United Facility/Professional Professional Modifier Low / Median / High Price $1,138.18 / $1,138.18 / $3,035.14	Professional		$1,138.18	$1,138.18	$3,035.14