Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $5,100.00 / $11,577.00 / $12,087.00	Facility		$5,100.00	$11,577.00	$12,087.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $4,860.00 / $5,100.00 / $8,823.00	Professional		$4,860.00	$5,100.00	$8,823.00
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $5,700.00 / $6,270.00 / $28,500.00	Facility		$5,700.00	$6,270.00	$28,500.00
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $5,700.00 / $5,700.00 / $27,000.00	Professional		$5,700.00	$5,700.00	$27,000.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,578.67 / $5,100.00 / $10,200.00	Facility		$2,578.67	$5,100.00	$10,200.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $5,100.00 / $5,100.00 / $5,100.00	Professional		$5,100.00	$5,100.00	$5,100.00
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $16,883.40 / $21,677.10 / $52,155.00	Facility		$16,883.40	$21,677.10	$52,155.00
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $5,700.00 / $6,015.68 / $6,015.68	Professional		$5,700.00	$6,015.68	$6,015.68
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $50.00 / $75.00	Professional		$50.00	$50.00	$75.00
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $5,700.00 / $5,700.00 / $79,999.20	Facility		$5,700.00	$5,700.00	$79,999.20
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $5,700.00 / $5,700.00 / $5,700.00	Facility		$5,700.00	$5,700.00	$5,700.00
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $5,700.00 / $5,700.00 / $5,700.00	Professional		$5,700.00	$5,700.00	$5,700.00
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $5,700.00 / $5,700.00 / $14,193.00	Facility		$5,700.00	$5,700.00	$14,193.00
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $5,415.00 / $5,700.00 / $5,928.00	Professional		$5,415.00	$5,700.00	$5,928.00
United Facility/Professional Professional Modifier Low / Median / High Price $5,000.00 / $5,000.00 / $6,000.00	Professional		$5,000.00	$5,000.00	$6,000.00