Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,880.00 / $3,186.20 / $11,020.00	Facility		$1,880.00	$3,186.20	$11,020.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,103.35 / $1,880.00 / $3,000.00	Professional		$1,103.35	$1,880.00	$3,000.00
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $2,100.00 / $3,200.00 / $8,262.79	Facility		$2,100.00	$3,200.00	$8,262.79
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $1,800.00 / $4,096.72 / $15,000.00	Professional		$1,800.00	$4,096.72	$15,000.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,080.00 / $3,250.00 / $5,164.25	Facility		$2,080.00	$3,250.00	$5,164.25
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,057.26 / $2,242.62 / $2,728.56	Professional		$1,057.26	$2,242.62	$2,728.56
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,973.77 / $2,500.00 / $5,709.28	Facility		$1,973.77	$2,500.00	$5,709.28
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $2,000.00 / $2,940.00 / $5,534.15	Professional		$2,000.00	$2,940.00	$5,534.15
Molina Facility/Professional Professional Modifier Low / Median / High Price $75.00 / $1,958.00 / $2,122.34	Professional		$75.00	$1,958.00	$2,122.34
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $2,000.00 / $2,000.00 / $4,200.00	Facility		$2,000.00	$2,000.00	$4,200.00
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,800.00 / $3,500.00 / $6,000.00	Facility		$1,800.00	$3,500.00	$6,000.00
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,800.00 / $2,500.00 / $3,020.00	Professional		$1,800.00	$2,500.00	$3,020.00
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $2,100.00 / $3,282.00 / $5,500.00	Facility		$2,100.00	$3,282.00	$5,500.00
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $2,212.00 / $3,891.89 / $4,650.18	Professional		$2,212.00	$3,891.89	$4,650.18
United Facility/Professional Professional Modifier Low / Median / High Price $840.00 / $840.00 / $2,200.00	Professional		$840.00	$840.00	$2,200.00