Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $3,525.00 / $5,550.00 / $20,662.50	Facility		$3,525.00	$5,550.00	$20,662.50
Aetna Facility/Professional Professional Modifier Low / Median / High Price $2,044.21 / $3,525.00 / $5,550.00	Professional		$2,044.21	$3,525.00	$5,550.00
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $3,937.50 / $6,000.00 / $15,492.75	Facility		$3,937.50	$6,000.00	$15,492.75
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $3,187.50 / $6,971.58 / $28,125.00	Professional		$3,187.50	$6,971.58	$28,125.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $3,900.00 / $7,678.13 / $9,750.00	Facility		$3,900.00	$7,678.13	$9,750.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,895.66 / $4,204.72 / $5,115.82	Professional		$1,895.66	$4,204.72	$5,115.82
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $3,700.78 / $4,739.39 / $11,599.68	Facility		$3,700.78	$4,739.39	$11,599.68
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $3,750.00 / $5,512.50 / $10,377.77	Professional		$3,750.00	$5,512.50	$10,377.77
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 $3,750.00 / $3,750.00 / $7,875.00	Facility		$3,750.00	$3,750.00	$7,875.00
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $3,750.00 / $6,562.50 / $11,250.00	Facility		$3,750.00	$6,562.50	$11,250.00
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $3,375.00 / $4,687.50 / $5,662.50	Professional		$3,375.00	$4,687.50	$5,662.50
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $3,937.50 / $6,153.75 / $10,312.50	Facility		$3,937.50	$6,153.75	$10,312.50
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $4,147.50 / $7,297.56 / $8,719.11	Professional		$4,147.50	$7,297.56	$8,719.11
United Facility/Professional Professional Modifier Low / Median / High Price $1,226.53 / $1,575.00 / $4,200.00	Professional		$1,226.53	$1,575.00	$4,200.00