Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,811.41 / $10,596.56 / $22,024.00	Facility		$1,811.41	$10,596.56	$22,024.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,605.86 / $1,811.41 / $1,811.41	Professional		$1,605.86	$1,811.41	$1,811.41
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $8,919.10 / $14,663.54 / $28,368.17	Facility		$8,919.10	$14,663.54	$28,368.17
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $3,475.97 / $3,475.97 / $3,475.97	Professional		$3,475.97	$3,475.97	$3,475.97
Cigna Facility/Professional Facility Modifier Low / Median / High Price $5,557.92 / $5,557.92 / $9,259.43	Facility		$5,557.92	$5,557.92	$9,259.43
Cigna Facility/Professional Professional Modifier Low / Median / High Price $2,116.30 / $2,116.30 / $2,116.30	Professional		$2,116.30	$2,116.30	$2,116.30
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $4,505.89 / $8,120.22 / $22,161.37	Facility		$4,505.89	$8,120.22	$22,161.37
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $13.10 / $6,238.57 / $8,469.62	Professional		$13.10	$6,238.57	$8,469.62
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $4,930.08 / $12,522.00 / $79,999.20	Facility		$4,930.08	$12,522.00	$79,999.20
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $3,576.77 / $3,576.77 / $3,576.77	Facility		$3,576.77	$3,576.77	$3,576.77
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $9,508.65 / $14,655.16 / $28,049.69	Facility		$9,508.65	$14,655.16	$28,049.69
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $3,475.97 / $3,475.97 / $3,475.97	Professional		$3,475.97	$3,475.97	$3,475.97
United Facility/Professional Facility Modifier Low / Median / High Price $1,550.00 / $2,431.00 / $11,261.00	Facility		$1,550.00	$2,431.00	$11,261.00