Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,748.25 / $2,884.61 / $4,143.35	Facility		$1,748.25	$2,884.61	$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 / $3,496.50	Facility		$1,748.25	$1,748.25	$3,496.50
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 $1,182.03 / $2,556.09 / $4,555.89	Facility		$1,182.03	$2,556.09	$4,555.89
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,182.03 / $2,592.52 / $4,732.95	Professional		$1,182.03	$2,592.52	$4,732.95
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 / $3,595.22	Facility		$1,953.92	$1,953.92	$3,595.22
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