Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $7,729.38 / $7,729.38 / $7,729.38	Facility		$7,729.38	$7,729.38	$7,729.38
Aetna Facility/Professional Professional Modifier Low / Median / High Price $7,729.38 / $7,729.38 / $12,185.37	Professional		$7,729.38	$7,729.38	$12,185.37
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $1,353.93 / $69,378.71 / $69,378.71	Facility		$1,353.93	$69,378.71	$69,378.71
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $1,623.53 / $10,823.54 / $114,102.15	Professional		$1,623.53	$10,823.54	$114,102.15
Cigna Facility/Professional Professional Modifier Low / Median / High Price $10,777.03 / $10,777.03 / $10,777.03	Professional		$10,777.03	$10,777.03	$10,777.03
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $9,216.92 / $18,113.15 / $26,465.02	Facility		$9,216.92	$18,113.15	$26,465.02
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $9,216.92 / $18,113.15 / $27,494.93	Professional		$9,216.92	$18,113.15	$27,494.93
Molina Facility/Professional Professional Modifier Low / Median / High Price $1,228.33 / $1,228.33 / $1,228.33	Professional		$1,228.33	$1,228.33	$1,228.33
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $21,558.35 / $25,894.32 / $26,261.99	Facility		$21,558.35	$25,894.32	$26,261.99
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $21,558.35 / $25,894.32 / $26,261.99	Professional		$21,558.35	$25,894.32	$26,261.99
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,353.93 / $1,353.93 / $1,353.93	Facility		$1,353.93	$1,353.93	$1,353.93
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $12,834.83 / $12,834.83 / $27,226.82	Professional		$12,834.83	$12,834.83	$27,226.82
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $1,044.08 / $1,044.08 / $1,271.28	Professional		$1,044.08	$1,044.08	$1,271.28
United Facility/Professional Professional Modifier Low / Median / High Price $6,062.44 / $6,567.65 / $10,845.65	Professional		$6,062.44	$6,567.65	$10,845.65
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $6,671.03 / $6,671.03 / $6,671.03	Professional		$6,671.03	$6,671.03	$6,671.03