Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,748.25 / $3,024.47 / $4,143.35	Facility		$1,748.25	$3,024.47	$4,143.35
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,665.98 / $1,748.25 / $1,768.81	Professional		$1,665.98	$1,748.25	$1,768.81
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $1,953.92 / $1,953.92 / $7,712.85	Facility		$1,953.92	$1,953.92	$7,712.85
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $1,758.53 / $1,953.92 / $9,255.42	Professional		$1,758.53	$1,953.92	$9,255.42
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,748.25 / $1,748.25 / $13,068.30	Facility		$1,748.25	$1,748.25	$13,068.30
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,748.25 / $1,748.25 / $1,748.25	Professional		$1,748.25	$1,748.25	$1,748.25
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,513.11 / $3,757.40 / $4,376.79	Facility		$1,513.11	$3,757.40	$4,376.79
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,513.11 / $3,757.40 / $4,416.10	Professional		$1,513.11	$3,757.40	$4,416.10
Molina Facility/Professional Professional Modifier Low / Median / High Price $75.00 / $75.00 / $2,149.31	Professional		$75.00	$75.00	$2,149.31
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,953.92 / $1,953.92 / $3,214.66	Facility		$1,953.92	$1,953.92	$3,214.66
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,953.92 / $1,953.92 / $1,953.92	Facility		$1,953.92	$1,953.92	$1,953.92
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,953.92 / $1,953.92 / $1,953.92	Professional		$1,953.92	$1,953.92	$1,953.92
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $1,953.92 / $1,953.92 / $1,953.92	Facility		$1,953.92	$1,953.92	$1,953.92
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $1,856.22 / $1,953.92 / $1,953.92	Professional		$1,856.22	$1,953.92	$1,953.92
United Facility/Professional Professional Modifier Low / Median / High Price $1,713.97 / $1,713.97 / $2,056.76	Professional		$1,713.97	$1,713.97	$2,056.76