Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,359.50 / $4,388.25 / $20,680.40	Facility		$2,359.50	$4,388.25	$20,680.40
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,576.48 / $2,359.50 / $4,421.04	Professional		$1,576.48	$2,359.50	$4,421.04
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $55.00 / $2,378.23 / $15,986.08	Facility		$55.00	$2,378.23	$15,986.08
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $2,447.96 / $4,182.78 / $15,332.10	Professional		$2,447.96	$4,182.78	$15,332.10
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 $1,732.66 / $3,061.32 / $5,173.79	Professional		$1,732.66	$3,061.32	$5,173.79
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,634.01 / $3,470.76 / $4,350.95	Facility		$1,634.01	$3,470.76	$4,350.95
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,634.01 / $3,346.36 / $4,381.35	Professional		$1,634.01	$3,346.36	$4,381.35
Molina Facility/Professional Professional Modifier Low / Median / High Price $168.26 / $637.57 / $3,848.61	Professional		$168.26	$637.57	$3,848.61
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $2,498.02 / $3,308.49 / $3,486.68	Facility		$2,498.02	$3,308.49	$3,486.68
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,353.79 / $2,353.79 / $2,378.23	Facility		$2,353.79	$2,353.79	$2,378.23
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $2,490.84 / $3,946.03 / $4,762.82	Professional		$2,490.84	$3,946.03	$4,762.82
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $2,779.86 / $3,421.11 / $4,470.24	Professional		$2,779.86	$3,421.11	$4,470.24
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 $1,830.46 / $2,859.43 / $5,007.09	Professional		$1,830.46	$2,859.43	$5,007.09
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,441.62 / $1,809.36 / $1,809.36	Professional		$1,441.62	$1,809.36	$1,809.36