Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,769.13 / $3,546.34 / $20,680.40	Facility		$1,769.13	$3,546.34	$20,680.40
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,203.33 / $1,694.26 / $3,546.34	Professional		$1,203.33	$1,694.26	$3,546.34
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $55.00 / $1,794.64 / $24,152.64	Facility		$55.00	$1,794.64	$24,152.64
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $1,867.68 / $3,135.27 / $11,542.20	Professional		$1,867.68	$3,135.27	$11,542.20
Cigna Facility/Professional Facility Modifier Low / Median / High Price $500.00 / $870.49 / $947.00	Facility		$500.00	$870.49	$947.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,335.62 / $2,352.96 / $3,906.53	Professional		$1,335.62	$2,352.96	$3,906.53
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,236.90 / $2,628.87 / $3,273.07	Facility		$1,236.90	$2,628.87	$3,273.07
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,236.90 / $2,555.82 / $3,318.60	Professional		$1,236.90	$2,555.82	$3,318.60
Molina Facility/Professional Professional Modifier Low / Median / High Price $109.15 / $463.10 / $2,900.12	Professional		$109.15	$463.10	$2,900.12
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,930.11 / $2,502.07 / $2,678.66	Facility		$1,930.11	$2,502.07	$2,678.66
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,762.62 / $1,762.62 / $1,794.64	Facility		$1,762.62	$1,762.62	$1,794.64
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,872.69 / $2,966.75 / $3,580.84	Professional		$1,872.69	$2,966.75	$3,580.84
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $2,081.69 / $2,581.61 / $3,373.29	Professional		$2,081.69	$2,581.61	$3,373.29
United Facility/Professional Facility Modifier Low / Median / High Price $650.00 / $1,120.00 / $5,793.00	Facility		$650.00	$1,120.00	$5,793.00
United Facility/Professional Professional Modifier Low / Median / High Price $1,456.94 / $2,144.44 / $3,764.48	Professional		$1,456.94	$2,144.44	$3,764.48
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,088.81 / $1,366.06 / $1,366.06	Professional		$1,088.81	$1,366.06	$1,366.06