Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,823.87 / $1,823.87 / $1,823.87	Facility		$1,823.87	$1,823.87	$1,823.87
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,238.00 / $1,823.87 / $1,823.87	Professional		$1,238.00	$1,823.87	$1,823.87
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $2,871.86 / $4,430.96 / $8,480.77	Facility		$2,871.86	$4,430.96	$8,480.77
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $602.78 / $1,052.22 / $9,962.67	Professional		$602.78	$1,052.22	$9,962.67
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,855.24 / $4,017.62 / $6,001.70	Facility		$1,855.24	$4,017.62	$6,001.70
Cigna Facility/Professional Professional Modifier Low / Median / High Price $566.19 / $1,023.89 / $1,543.25	Professional		$566.19	$1,023.89	$1,543.25
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,511.56 / $2,555.02 / $6,659.19	Facility		$1,511.56	$2,555.02	$6,659.19
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,638.97 / $2,501.32 / $3,970.17	Professional		$1,638.97	$2,501.32	$3,970.17
Molina Facility/Professional Professional Modifier Low / Median / High Price $31.04 / $171.46 / $223.37	Professional		$31.04	$171.46	$223.37
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $671.15 / $796.44 / $972.47	Facility		$671.15	$796.44	$972.47
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $956.60 / $956.60 / $956.60	Professional		$956.60	$956.60	$956.60
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $602.78 / $602.78 / $2,500.00	Facility		$602.78	$602.78	$2,500.00
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $667.81 / $1,015.66 / $1,236.30	Professional		$667.81	$1,015.66	$1,236.30
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $2,871.86 / $4,326.32 / $8,431.12	Facility		$2,871.86	$4,326.32	$8,431.12
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $600.60 / $910.00 / $1,237.75	Professional		$600.60	$910.00	$1,237.75
United Facility/Professional Professional Modifier Low / Median / High Price $731.65 / $1,559.83 / $4,372.85	Professional		$731.65	$1,559.83	$4,372.85