Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,377.00 / $1,377.00 / $1,377.00	Facility		$1,377.00	$1,377.00	$1,377.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,296.00 / $1,377.00 / $1,377.00	Professional		$1,296.00	$1,377.00	$1,377.00
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $1,344.60 / $2,101.19 / $5,737.50	Facility		$1,344.60	$2,101.19	$5,737.50
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $1,377.00 / $3,363.13 / $6,885.00	Professional		$1,377.00	$3,363.13	$6,885.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,377.00 / $1,377.00 / $2,754.00	Facility		$1,377.00	$1,377.00	$2,754.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,377.00 / $1,377.00 / $1,377.00	Professional		$1,377.00	$1,377.00	$1,377.00
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $3,792.77 / $3,792.77 / $3,792.77	Professional		$3,792.77	$3,792.77	$3,792.77
Molina Facility/Professional Professional Modifier Low / Median / High Price $45.00 / $50.00 / $50.00	Professional		$45.00	$50.00	$50.00
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,902.45 / $2,317.53 / $2,317.53	Facility		$1,902.45	$2,317.53	$2,317.53
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,344.60 / $1,344.60 / $1,377.00	Facility		$1,344.60	$1,344.60	$1,377.00
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,247.40 / $1,377.00 / $1,458.00	Professional		$1,247.40	$1,377.00	$1,458.00
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $1,889.51 / $2,496.81 / $3,363.13	Professional		$1,889.51	$2,496.81	$3,363.13
United Facility/Professional Professional Modifier Low / Median / High Price $1,350.00 / $1,350.00 / $1,620.00	Professional		$1,350.00	$1,350.00	$1,620.00
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,000.00 / $1,000.00 / $1,000.00	Professional		$1,000.00	$1,000.00	$1,000.00