Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $4,500.00 / $13,409.00 / $31,602.88	Facility		$4,500.00	$13,409.00	$31,602.88
Aetna Facility/Professional Professional Modifier Low / Median / High Price $806.00 / $3,529.60 / $3,529.60	Professional		$806.00	$3,529.60	$3,529.60
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $2,800.00 / $15,326.73 / $31,278.54	Facility		$2,800.00	$15,326.73	$31,278.54
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $2,024.35 / $64,999.35 / $64,999.35	Professional		$2,024.35	$64,999.35	$64,999.35
Cigna Facility/Professional Facility Modifier Low / Median / High Price $500.00 / $714.97 / $947.00	Facility		$500.00	$714.97	$947.00
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $5,167.68 / $9,716.85 / $38,422.04	Facility		$5,167.68	$9,716.85	$38,422.04
Molina Facility/Professional Professional Modifier Low / Median / High Price $45.00 / $50.00 / $60.00	Professional		$45.00	$50.00	$60.00
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $4,548.16 / $8,714.00 / $13,964.00	Facility		$4,548.16	$8,714.00	$13,964.00
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $10,603.20 / $16,351.48 / $31,278.54	Facility		$10,603.20	$16,351.48	$31,278.54
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $2,671.69 / $3,385.04 / $5,464.82	Professional		$2,671.69	$3,385.04	$5,464.82
United Facility/Professional Facility Modifier Low / Median / High Price $1,400.00 / $3,509.00 / $16,315.00	Facility		$1,400.00	$3,509.00	$16,315.00
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $750.00 / $750.00 / $750.00	Professional		$750.00	$750.00	$750.00