Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $4,294.16 / $7,428.90 / $10,177.20	Facility		$4,294.16	$7,428.90	$10,177.20
Aetna Facility/Professional Professional Modifier Low / Median / High Price $4,092.08 / $4,294.16 / $4,344.68	Professional		$4,092.08	$4,294.16	$4,344.68
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $4,799.35 / $4,799.35 / $18,944.81	Facility		$4,799.35	$4,799.35	$18,944.81
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $4,319.42 / $4,799.35 / $22,733.78	Professional		$4,319.42	$4,799.35	$22,733.78
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,501.12 / $4,294.16 / $8,588.32	Facility		$2,501.12	$4,294.16	$8,588.32
Cigna Facility/Professional Professional Modifier Low / Median / High Price $4,294.16 / $4,294.16 / $4,294.16	Professional		$4,294.16	$4,294.16	$4,294.16
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $3,777.04 / $8,894.79 / $10,925.39	Facility		$3,777.04	$8,894.79	$10,925.39
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $3,777.04 / $9,111.83 / $10,992.51	Professional		$3,777.04	$9,111.83	$10,992.51
Molina Facility/Professional Professional Modifier Low / Median / High Price $75.00 / $75.00 / $5,279.28	Professional		$75.00	$75.00	$5,279.28
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $4,799.35 / $4,799.35 / $8,351.54	Facility		$4,799.35	$4,799.35	$8,351.54
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $4,799.35 / $4,799.35 / $4,799.35	Facility		$4,799.35	$4,799.35	$4,799.35
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $4,799.35 / $4,799.35 / $4,799.35	Professional		$4,799.35	$4,799.35	$4,799.35
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $4,799.35 / $4,799.35 / $4,799.35	Facility		$4,799.35	$4,799.35	$4,799.35
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $4,559.38 / $4,799.35 / $4,799.35	Professional		$4,559.38	$4,799.35	$4,799.35
United Facility/Professional Professional Modifier Low / Median / High Price $4,209.96 / $4,209.96 / $5,051.95	Professional		$4,209.96	$4,209.96	$5,051.95