Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $4,483.93 / $7,757.20 / $10,626.90	Facility		$4,483.93	$7,757.20	$10,626.90
Aetna Facility/Professional Professional Modifier Low / Median / High Price $4,272.92 / $4,483.93 / $5,254.10	Professional		$4,272.92	$4,483.93	$5,254.10
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $835.24 / $3,193.12 / $7,187.97	Facility		$835.24	$3,193.12	$7,187.97
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $835.24 / $835.24 / $10,240.87	Professional		$835.24	$835.24	$10,240.87
Cigna Facility/Professional Facility Modifier Low / Median / High Price $4,483.93 / $4,483.93 / $8,967.86	Facility		$4,483.93	$4,483.93	$8,967.86
Cigna Facility/Professional Professional Modifier Low / Median / High Price $4,483.93 / $4,483.93 / $4,483.93	Professional		$4,483.93	$4,483.93	$4,483.93
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,569.43 / $2,432.54 / $3,598.12	Facility		$1,569.43	$2,432.54	$3,598.12
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,569.43 / $2,571.64 / $3,598.12	Professional		$1,569.43	$2,571.64	$3,598.12
Molina Facility/Professional Professional Modifier Low / Median / High Price $75.00 / $75.00 / $918.76	Professional		$75.00	$75.00	$918.76
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $835.24 / $835.24 / $2,357.06	Facility		$835.24	$835.24	$2,357.06
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $835.24 / $835.24 / $835.24	Facility		$835.24	$835.24	$835.24
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $835.24 / $835.24 / $835.24	Professional		$835.24	$835.24	$835.24
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $835.24 / $835.24 / $835.24	Facility		$835.24	$835.24	$835.24
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $793.48 / $835.24 / $835.24	Professional		$793.48	$835.24	$835.24
United Facility/Professional Professional Modifier Low / Median / High Price $5,275.21 / $5,275.21 / $6,330.25	Professional		$5,275.21	$5,275.21	$6,330.25