Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,469.27 / $4,362.33 / $5,966.14	Facility		$2,469.27	$4,362.33	$5,966.14
Aetna Facility/Professional Professional Modifier Low / Median / High Price $2,581.63 / $2,643.84 / $2,839.79	Professional		$2,581.63	$2,643.84	$2,839.79
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $2,569.17 / $6,801.30 / $11,106.00	Facility		$2,569.17	$6,801.30	$11,106.00
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $2,813.52 / $2,954.88 / $13,327.20	Professional		$2,813.52	$2,954.88	$13,327.20
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,643.84 / $2,643.84 / $5,034.72	Facility		$2,643.84	$2,643.84	$5,034.72
Cigna Facility/Professional Professional Modifier Low / Median / High Price $2,643.84 / $2,643.84 / $2,643.84	Professional		$2,643.84	$2,643.84	$2,643.84
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $5,645.22 / $8,982.41 / $17,438.80	Facility		$5,645.22	$8,982.41	$17,438.80
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $2,969.33 / $2,969.33 / $2,969.33	Professional		$2,969.33	$2,969.33	$2,969.33
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $50.00 / $3,094.87	Professional		$50.00	$50.00	$3,094.87
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 $2,813.52 / $2,813.52 / $2,813.52	Facility		$2,813.52	$2,813.52	$2,813.52
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $2,813.52 / $2,813.52 / $2,813.52	Professional		$2,813.52	$2,813.52	$2,813.52
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $2,335.62 / $2,569.17 / $2,954.88	Facility		$2,335.62	$2,569.17	$2,954.88
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $2,807.14 / $2,954.88 / $2,954.88	Professional		$2,807.14	$2,954.88	$2,954.88
United Facility/Professional Professional Modifier Low / Median / High Price $2,592.00 / $2,592.00 / $3,110.40	Professional		$2,592.00	$2,592.00	$3,110.40