Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $3,384.00 / $8,201.16 / $19,836.00	Facility		$3,384.00	$8,201.16	$19,836.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $2,520.00 / $3,600.00 / $3,600.00	Professional		$2,520.00	$3,600.00	$3,600.00
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $3,780.00 / $5,760.00 / $14,873.04	Facility		$3,780.00	$5,760.00	$14,873.04
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $3,240.55 / $7,360.79 / $27,000.00	Professional		$3,240.55	$7,360.79	$27,000.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $3,744.00 / $7,652.50 / $9,295.65	Facility		$3,744.00	$7,652.50	$9,295.65
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,776.14 / $3,914.18 / $5,262.68	Professional		$1,776.14	$3,914.18	$5,262.68
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $3,600.00 / $4,500.00 / $12,321.56	Facility		$3,600.00	$4,500.00	$12,321.56
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $3,600.00 / $6,120.00 / $11,135.40	Professional		$3,600.00	$6,120.00	$11,135.40
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 $3,600.00 / $3,780.00 / $5,400.00	Facility		$3,600.00	$3,780.00	$5,400.00
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $3,600.00 / $6,300.00 / $10,800.00	Facility		$3,600.00	$6,300.00	$10,800.00
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $3,240.00 / $4,500.00 / $5,436.00	Professional		$3,240.00	$4,500.00	$5,436.00
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $3,780.00 / $5,760.00 / $9,900.00	Facility		$3,780.00	$5,760.00	$9,900.00
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $3,981.60 / $7,005.96 / $8,370.81	Professional		$3,981.60	$7,005.96	$8,370.81
United Facility/Professional Professional Modifier Low / Median / High Price $1,512.00 / $1,512.00 / $4,032.00	Professional		$1,512.00	$1,512.00	$4,032.00