Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,745.64 / $1,746.00 / $2,624.49	Professional		$1,745.64	$1,746.00	$2,624.49
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $119.60 / $15,669.80 / $15,669.80	Facility		$119.60	$15,669.80	$15,669.80
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $1,938.71 / $2,570.80 / $3,666.60	Professional		$1,938.71	$2,570.80	$3,666.60
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,160.00 / $2,160.00 / $2,160.00	Facility		$2,160.00	$2,160.00	$2,160.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $259.14 / $2,160.00 / $2,904.98	Professional		$259.14	$2,160.00	$2,904.98
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $3,492.00 / $3,492.00 / $3,492.00	Facility		$3,492.00	$3,492.00	$3,492.00
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $3,492.00 / $3,492.00 / $3,492.00	Professional		$3,492.00	$3,492.00	$3,492.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $2,409.39 / $2,677.10 / $2,944.81	Professional		$2,409.39	$2,677.10	$2,944.81
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $4,869.14 / $5,848.47 / $5,931.51	Facility		$4,869.14	$5,848.47	$5,931.51
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $4,869.14 / $5,848.47 / $5,931.51	Professional		$4,869.14	$5,848.47	$5,931.51
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $305.77 / $305.77 / $305.77	Facility		$305.77	$305.77	$305.77
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $3,410.20 / $3,410.20 / $3,921.73	Professional		$3,410.20	$3,410.20	$3,921.73
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $235.81 / $235.81 / $287.12	Professional		$235.81	$235.81	$287.12
United Facility/Professional Professional Modifier Low / Median / High Price $1,273.26 / $1,469.64 / $2,449.40	Professional		$1,273.26	$1,469.64	$2,449.40
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $2,387.46 / $2,387.46 / $2,387.46	Professional		$2,387.46	$2,387.46	$2,387.46