Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $3,468.00 / $3,468.00 / $3,468.00	Facility		$3,468.00	$3,468.00	$3,468.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $3,304.80 / $3,386.40 / $3,725.04	Professional		$3,304.80	$3,386.40	$3,725.04
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $3,876.00 / $15,300.00 / $15,300.00	Facility		$3,876.00	$15,300.00	$15,300.00
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $3,400.00 / $3,876.00 / $18,360.00	Professional		$3,400.00	$3,876.00	$18,360.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $3,088.87 / $3,468.00 / $11,424.00	Facility		$3,088.87	$3,468.00	$11,424.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $3,468.00 / $3,468.00 / $3,468.00	Professional		$3,468.00	$3,468.00	$3,468.00
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $3,876.00 / $8,883.82 / $27,157.20	Facility		$3,876.00	$8,883.82	$27,157.20
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $3,368.79 / $3,368.79 / $3,876.00	Professional		$3,368.79	$3,368.79	$3,876.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $50.00 / $75.00	Professional		$50.00	$50.00	$75.00
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $3,876.00 / $3,876.00 / $3,876.00	Facility		$3,876.00	$3,876.00	$3,876.00
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $3,876.00 / $3,876.00 / $3,876.00	Facility		$3,876.00	$3,876.00	$3,876.00
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $3,876.00 / $3,876.00 / $3,876.00	Professional		$3,876.00	$3,876.00	$3,876.00
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $2,968.00 / $3,876.00 / $7,390.32	Facility		$2,968.00	$3,876.00	$7,390.32
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $3,876.00 / $3,876.00 / $4,031.04	Professional		$3,876.00	$3,876.00	$4,031.04
United Facility/Professional Professional Modifier Low / Median / High Price $3,400.00 / $3,400.00 / $4,080.00	Professional		$3,400.00	$3,400.00	$4,080.00