Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,249.37 / $2,249.37 / $2,249.37	Facility		$2,249.37	$2,249.37	$2,249.37
Aetna Facility/Professional Professional Modifier Low / Median / High Price $2,249.37 / $3,579.01 / $7,933.82	Professional		$2,249.37	$3,579.01	$7,933.82
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $3,305.09 / $21,409.68 / $21,409.68	Facility		$3,305.09	$21,409.68	$21,409.68
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $4,045.27 / $7,266.52 / $29,872.58	Professional		$4,045.27	$7,266.52	$29,872.58
Cigna Facility/Professional Professional Modifier Low / Median / High Price $2,821.49 / $2,821.49 / $2,821.49	Professional		$2,821.49	$2,821.49	$2,821.49
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,374.24 / $3,184.90 / $6,643.37	Facility		$1,374.24	$3,184.90	$6,643.37
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,570.56 / $3,220.78 / $6,739.76	Professional		$1,570.56	$3,220.78	$6,739.76
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 $886.14 / $1,066.59 / $1,174.32	Facility		$886.14	$1,066.59	$1,174.32
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $3,305.09 / $3,305.09 / $4,689.72	Facility		$3,305.09	$3,305.09	$4,689.72
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $4,941.79 / $7,266.52 / $9,308.66	Professional		$4,941.79	$7,266.52	$9,308.66
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $7,625.14 / $7,625.14 / $9,606.51	Facility		$7,625.14	$7,625.14	$9,606.51
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $4,045.27 / $6,417.85 / $8,815.06	Professional		$4,045.27	$6,417.85	$8,815.06
United Facility/Professional Facility Modifier Low / Median / High Price $2,912.00 / $8,242.00 / $17,644.00	Facility		$2,912.00	$8,242.00	$17,644.00
United Facility/Professional Professional Modifier Low / Median / High Price $1,636.01 / $3,284.80 / $8,148.07	Professional		$1,636.01	$3,284.80	$8,148.07