Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,780.44 / $1,780.44 / $1,780.44	Facility		$1,780.44	$1,780.44	$1,780.44
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,780.44 / $2,938.68 / $4,783.53	Professional		$1,780.44	$2,938.68	$4,783.53
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $2,616.08 / $17,222.12 / $17,222.12	Facility		$2,616.08	$17,222.12	$17,222.12
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $3,278.81 / $5,961.40 / $24,528.00	Professional		$3,278.81	$5,961.40	$24,528.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $2,316.69 / $2,316.69 / $2,316.69	Professional		$2,316.69	$2,316.69	$2,316.69
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,858.45 / $3,568.91 / $5,278.59	Facility		$1,858.45	$3,568.91	$5,278.59
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,997.76 / $3,568.91 / $5,355.24	Professional		$1,997.76	$3,568.91	$5,355.24
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 $1,127.08 / $1,493.70 / $1,607.87	Facility		$1,127.08	$1,493.70	$1,607.87
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,616.08 / $2,616.08 / $3,850.68	Facility		$2,616.08	$2,616.08	$3,850.68
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $4,018.16 / $5,951.76 / $7,643.22	Professional		$4,018.16	$5,951.76	$7,643.22
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $5,440.04 / $5,440.04 / $6,853.62	Facility		$5,440.04	$5,440.04	$6,853.62
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $3,278.81 / $5,177.78 / $7,237.93	Professional		$3,278.81	$5,177.78	$7,237.93
United Facility/Professional Facility Modifier Low / Median / High Price $2,155.00 / $6,594.00 / $12,835.00	Facility		$2,155.00	$6,594.00	$12,835.00
United Facility/Professional Professional Modifier Low / Median / High Price $1,636.01 / $2,394.69 / $6,068.41	Professional		$1,636.01	$2,394.69	$6,068.41