Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $5,170.00 / $12,404.30 / $30,002.00	Facility		$5,170.00	$12,404.30	$30,002.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $3,465.00 / $5,170.00 / $8,169.60	Professional		$3,465.00	$5,170.00	$8,169.60
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $5,775.00 / $8,800.00 / $22,722.70	Facility		$5,775.00	$8,800.00	$22,722.70
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $4,950.85 / $11,429.03 / $41,250.00	Professional		$4,950.85	$11,429.03	$41,250.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $5,720.00 / $11,691.32 / $14,201.69	Facility		$5,720.00	$11,691.32	$14,201.69
Cigna Facility/Professional Professional Modifier Low / Median / High Price $2,713.53 / $5,979.97 / $8,040.16	Professional		$2,713.53	$5,979.97	$8,040.16
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $5,445.00 / $6,806.25 / $18,825.00	Facility		$5,445.00	$6,806.25	$18,825.00
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $5,445.00 / $9,256.50 / $17,012.78	Professional		$5,445.00	$9,256.50	$17,012.78
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 $5,445.00 / $5,500.00 / $7,623.00	Facility		$5,445.00	$5,500.00	$7,623.00
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $5,500.00 / $9,625.00 / $16,500.00	Facility		$5,500.00	$9,625.00	$16,500.00
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $4,950.00 / $6,900.00 / $8,335.20	Professional		$4,950.00	$6,900.00	$8,335.20
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $5,775.00 / $8,800.00 / $15,125.00	Facility		$5,775.00	$8,800.00	$15,125.00
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $6,022.17 / $10,703.22 / $12,788.80	Professional		$6,022.17	$10,703.22	$12,788.80
United Facility/Professional Professional Modifier Low / Median / High Price $2,310.00 / $2,310.00 / $6,182.40	Professional		$2,310.00	$2,310.00	$6,182.40