Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $3,739.65 / $6,469.59 / $8,862.96	Facility		$3,739.65	$6,469.59	$8,862.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $3,563.67 / $3,739.65 / $3,783.65	Professional		$3,563.67	$3,739.65	$3,783.65
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $3,844.31 / $4,179.60 / $16,017.94	Facility		$3,844.31	$4,179.60	$16,017.94
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $3,761.65 / $4,179.60 / $19,221.53	Professional		$3,761.65	$4,179.60	$19,221.53
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,658.22 / $3,739.65 / $7,479.30	Facility		$1,658.22	$3,739.65	$7,479.30
Cigna Facility/Professional Professional Modifier Low / Median / High Price $3,739.65 / $3,739.65 / $3,739.65	Professional		$3,739.65	$3,739.65	$3,739.65
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $395.25 / $972.19 / $1,156.70	Facility		$395.25	$972.19	$1,156.70
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $395.25 / $983.88 / $1,308.54	Professional		$395.25	$983.88	$1,308.54
Molina Facility/Professional Professional Modifier Low / Median / High Price $75.00 / $75.00 / $4,597.57	Professional		$75.00	$75.00	$4,597.57
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $2,648.25 / $3,226.05 / $3,226.05	Facility		$2,648.25	$3,226.05	$3,226.05
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $4,179.60 / $4,179.60 / $4,179.60	Facility		$4,179.60	$4,179.60	$4,179.60
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $4,179.60 / $4,179.60 / $4,179.60	Professional		$4,179.60	$4,179.60	$4,179.60
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $4,179.60 / $4,179.60 / $4,179.60	Facility		$4,179.60	$4,179.60	$4,179.60
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $3,970.63 / $4,179.60 / $4,179.60	Professional		$3,970.63	$4,179.60	$4,179.60
United Facility/Professional Professional Modifier Low / Median / High Price $3,666.33 / $3,666.33 / $4,399.60	Professional		$3,666.33	$3,666.33	$4,399.60