Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,924.65 / $3,734.20 / $20,680.40	Facility		$1,924.65	$3,734.20	$20,680.40
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,312.13 / $1,850.45 / $3,734.20	Professional		$1,312.13	$1,850.45	$3,734.20
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $55.00 / $1,955.50 / $26,294.08	Facility		$55.00	$1,955.50	$26,294.08
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $2,088.15 / $3,383.25 / $12,580.73	Professional		$2,088.15	$3,383.25	$12,580.73
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 $1,440.26 / $2,514.54 / $4,247.58	Professional		$1,440.26	$2,514.54	$4,247.58
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,354.08 / $2,884.86 / $3,593.67	Facility		$1,354.08	$2,884.86	$3,593.67
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,354.08 / $2,781.46 / $3,641.74	Professional		$1,354.08	$2,781.46	$3,641.74
Molina Facility/Professional Professional Modifier Low / Median / High Price $134.52 / $523.64 / $3,191.27	Professional		$134.52	$523.64	$3,191.27
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $2,053.10 / $2,720.21 / $2,866.93	Facility		$2,053.10	$2,720.21	$2,866.93
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,925.25 / $1,925.25 / $1,955.50	Facility		$1,925.25	$1,925.25	$1,955.50
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $2,041.54 / $3,239.15 / $3,909.63	Professional		$2,041.54	$3,239.15	$3,909.63
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $2,273.75 / $2,813.02 / $3,676.25	Professional		$2,273.75	$2,813.02	$3,676.25
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 $1,491.06 / $2,409.94 / $4,192.78	Professional		$1,491.06	$2,409.94	$4,192.78
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,185.71 / $1,478.91 / $1,478.91	Professional		$1,185.71	$1,478.91	$1,478.91