Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,929.04 / $5,203.72 / $17,169.20	Facility		$2,929.04	$5,203.72	$17,169.20
Aetna Facility/Professional Professional Modifier Low / Median / High Price $320.58 / $2,929.04 / $5,251.23	Professional		$320.58	$2,929.04	$5,251.23
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $3,271.80 / $4,985.60 / $12,873.44	Facility		$3,271.80	$4,985.60	$12,873.44
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $2,804.40 / $6,088.01 / $23,370.00	Professional		$2,804.40	$6,088.01	$23,370.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $3,240.64 / $6,623.67 / $8,134.01	Facility		$3,240.64	$6,623.67	$8,134.01
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,583.27 / $3,493.91 / $4,250.97	Professional		$1,583.27	$3,493.91	$4,250.97
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $3,075.20 / $3,937.95 / $9,638.29	Facility		$3,075.20	$3,937.95	$9,638.29
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $3,116.00 / $4,580.52 / $8,623.00	Professional		$3,116.00	$4,580.52	$8,623.00
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 $3,116.00 / $3,116.00 / $6,543.60	Facility		$3,116.00	$3,116.00	$6,543.60
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $3,116.00 / $5,453.00 / $9,348.00	Facility		$3,116.00	$5,453.00	$9,348.00
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $2,804.40 / $3,895.00 / $4,705.16	Professional		$2,804.40	$3,895.00	$4,705.16
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $3,271.80 / $5,113.35 / $8,569.00	Facility		$3,271.80	$5,113.35	$8,569.00
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $3,446.30 / $6,063.79 / $7,245.41	Professional		$3,446.30	$6,063.79	$7,245.41
United Facility/Professional Professional Modifier Low / Median / High Price $1,308.72 / $1,312.81 / $3,489.92	Professional		$1,308.72	$1,312.81	$3,489.92