Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $3,825.00 / $8,682.75 / $9,065.25	Facility		$3,825.00	$8,682.75	$9,065.25
Aetna Facility/Professional Professional Modifier Low / Median / High Price $3,645.00 / $3,825.00 / $4,482.00	Professional		$3,645.00	$3,825.00	$4,482.00
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $4,146.34 / $6,219.51 / $12,853.65	Facility		$4,146.34	$6,219.51	$12,853.65
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $4,061.25 / $4,275.00 / $20,250.00	Professional		$4,061.25	$4,275.00	$20,250.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $3,825.00 / $3,825.00 / $7,650.00	Facility		$3,825.00	$3,825.00	$7,650.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $3,825.00 / $3,825.00 / $3,825.00	Professional		$3,825.00	$3,825.00	$3,825.00
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $507.15 / $1,041.00 / $12,281.46	Facility		$507.15	$1,041.00	$12,281.46
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $507.15 / $988.86 / $1,337.81	Professional		$507.15	$988.86	$1,337.81
Molina Facility/Professional Professional Modifier Low / Median / High Price $75.00 / $75.00 / $4,702.50	Professional		$75.00	$75.00	$4,702.50
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 $3,740.92 / $6,650.52 / $11,638.40	Facility		$3,740.92	$6,650.52	$11,638.40
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $4,275.00 / $4,275.00 / $4,275.00	Professional		$4,275.00	$4,275.00	$4,275.00
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $3,758.33 / $4,975.60 / $9,231.83	Facility		$3,758.33	$4,975.60	$9,231.83
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $4,061.25 / $4,275.00 / $4,275.00	Professional		$4,061.25	$4,275.00	$4,275.00
United Facility/Professional Professional Modifier Low / Median / High Price $3,750.00 / $3,750.00 / $4,500.00	Professional		$3,750.00	$3,750.00	$4,500.00