Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,956.62 / $4,471.43 / $22,024.00	Facility		$1,956.62	$4,471.43	$22,024.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,454.30 / $1,956.62 / $4,471.43	Professional		$1,454.30	$1,956.62	$4,471.43
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $55.00 / $5,000.00 / $20,302.15	Facility		$55.00	$5,000.00	$20,302.15
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $2,313.61 / $3,762.54 / $14,746.88	Professional		$2,313.61	$3,762.54	$14,746.88
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,000.00 / $2,285.42 / $2,285.42	Facility		$2,000.00	$2,285.42	$2,285.42
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,609.27 / $2,824.19 / $4,802.50	Professional		$1,609.27	$2,824.19	$4,802.50
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,486.72 / $2,982.93 / $3,862.01	Facility		$1,486.72	$2,982.93	$3,862.01
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,516.52 / $2,982.93 / $4,005.38	Professional		$1,516.52	$2,982.93	$4,005.38
Molina Facility/Professional Professional Modifier Low / Median / High Price $162.32 / $648.92 / $3,276.45	Professional		$162.32	$648.92	$3,276.45
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $2,272.79 / $3,044.75 / $3,262.90	Facility		$2,272.79	$3,044.75	$3,262.90
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,149.48 / $2,149.48 / $2,225.59	Facility		$2,149.48	$2,149.48	$2,225.59
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $2,477.54 / $3,540.49 / $4,417.58	Professional		$2,477.54	$3,540.49	$4,417.58
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $2,192.19 / $3,167.84 / $4,217.42	Professional		$2,192.19	$3,167.84	$4,217.42
United Facility/Professional Facility Modifier Low / Median / High Price $702.00 / $1,389.00 / $5,793.00	Facility		$702.00	$1,389.00	$5,793.00
United Facility/Professional Professional Modifier Low / Median / High Price $1,929.90 / $2,527.25 / $4,655.64	Professional		$1,929.90	$2,527.25	$4,655.64
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,351.35 / $1,351.35 / $1,696.16	Professional		$1,351.35	$1,351.35	$1,696.16