Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $3,049.99 / $3,049.99 / $3,049.99	Facility		$3,049.99	$3,049.99	$3,049.99
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,650.67 / $3,049.99 / $3,484.42	Professional		$1,650.67	$3,049.99	$3,484.42
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $3,205.54 / $5,709.19 / $11,993.29	Facility		$3,205.54	$5,709.19	$11,993.29
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $1,868.89 / $1,868.89 / $2,651.99	Professional		$1,868.89	$1,868.89	$2,651.99
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,275.00 / $1,275.00 / $1,275.00	Professional		$1,275.00	$1,275.00	$1,275.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $399.83 / $488.68 / $3,087.02	Professional		$399.83	$488.68	$3,087.02
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $3,575.01 / $3,575.01 / $79,999.20	Facility		$3,575.01	$3,575.01	$79,999.20
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $3,575.01 / $3,575.01 / $3,660.81	Professional		$3,575.01	$3,575.01	$3,660.81
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $507.44 / $5,112.26 / $8,462.04	Facility		$507.44	$5,112.26	$8,462.04
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,020.44 / $3,575.01 / $3,575.01	Professional		$1,020.44	$3,575.01	$3,575.01
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $4,542.91 / $5,451.50 / $10,357.84	Facility		$4,542.91	$5,451.50	$10,357.84
United Facility/Professional Professional Modifier Low / Median / High Price $3,373.71 / $4,042.76 / $9,927.67	Professional		$3,373.71	$4,042.76	$9,927.67