Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $5,210.58 / $9,014.29 / $12,349.10	Facility		$5,210.58	$9,014.29	$12,349.10
Aetna Facility/Professional Professional Modifier Low / Median / High Price $4,965.37 / $5,210.58 / $5,271.88	Professional		$4,965.37	$5,210.58	$5,271.88
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $5,823.59 / $10,166.57 / $21,893.18	Facility		$5,823.59	$10,166.57	$21,893.18
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $5,823.59 / $5,823.59 / $26,271.81	Professional		$5,823.59	$5,823.59	$26,271.81
Cigna Facility/Professional Facility Modifier Low / Median / High Price $5,210.58 / $5,210.58 / $10,623.42	Facility		$5,210.58	$5,210.58	$10,623.42
Cigna Facility/Professional Professional Modifier Low / Median / High Price $5,210.58 / $5,210.58 / $5,210.58	Professional		$5,210.58	$5,210.58	$5,210.58
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $2.50 / $4,769.54 / $12,424.22	Facility		$2.50	$4,769.54	$12,424.22
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $2.50 / $4,769.54 / $6,883.96	Professional		$2.50	$4,769.54	$6,883.96
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $1,031.55 / $1,983.75	Professional		$50.00	$1,031.55	$1,983.75
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $79,999.20 / $79,999.20 / $79,999.20	Facility		$79,999.20	$79,999.20	$79,999.20
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $5,823.59 / $5,823.59 / $5,823.59	Facility		$5,823.59	$5,823.59	$5,823.59
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $5,823.59 / $5,823.59 / $5,823.59	Professional		$5,823.59	$5,823.59	$5,823.59
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $5,823.59 / $5,823.59 / $5,823.59	Facility		$5,823.59	$5,823.59	$5,823.59
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $5,532.41 / $5,823.59 / $5,823.59	Professional		$5,532.41	$5,823.59	$5,823.59
United Facility/Professional Professional Modifier Low / Median / High Price $5,108.41 / $5,108.41 / $6,130.09	Professional		$5,108.41	$5,108.41	$6,130.09