Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,698.74 / $4,249.08 / $15,819.20	Facility		$2,698.74	$4,249.08	$15,819.20
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,488.75 / $2,698.74 / $4,249.08	Professional		$1,488.75	$2,698.74	$4,249.08
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $3,014.55 / $4,593.60 / $11,861.25	Facility		$3,014.55	$4,593.60	$11,861.25
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $2,440.35 / $5,337.36 / $21,532.50	Professional		$2,440.35	$5,337.36	$21,532.50
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,985.84 / $5,878.37 / $7,464.60	Facility		$2,985.84	$5,878.37	$7,464.60
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,451.27 / $3,219.27 / $3,916.83	Professional		$1,451.27	$3,219.27	$3,916.83
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $2,833.09 / $3,628.35 / $8,880.85	Facility		$2,833.09	$3,628.35	$8,880.85
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $2,871.00 / $4,220.37 / $7,945.35	Professional		$2,871.00	$4,220.37	$7,945.35
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 $2,871.00 / $2,871.00 / $6,029.10	Facility		$2,871.00	$2,871.00	$6,029.10
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,871.00 / $5,024.25 / $8,613.00	Facility		$2,871.00	$5,024.25	$8,613.00
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $2,583.90 / $3,588.75 / $4,335.21	Professional		$2,583.90	$3,588.75	$4,335.21
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $3,014.55 / $4,711.31 / $7,895.25	Facility		$3,014.55	$4,711.31	$7,895.25
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $3,175.33 / $5,586.98 / $6,675.75	Professional		$3,175.33	$5,586.98	$6,675.75
United Facility/Professional Professional Modifier Low / Median / High Price $893.25 / $1,205.82 / $3,215.52	Professional		$893.25	$1,205.82	$3,215.52