Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,167.72 / $1,334.34 / $2,103.57	Professional		$1,167.72	$1,334.34	$2,103.57
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $233.73 / $11,977.62 / $11,977.62	Facility		$233.73	$11,977.62	$11,977.62
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $1,482.04 / $1,997.01 / $2,606.69	Professional		$1,482.04	$1,997.01	$2,606.69
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,639.62 / $1,639.62 / $1,639.62	Facility		$1,639.62	$1,639.62	$1,639.62
Cigna Facility/Professional Professional Modifier Low / Median / High Price $198.09 / $1,393.68 / $1,639.62	Professional		$198.09	$1,393.68	$1,639.62
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $2,669.30 / $2,669.30 / $2,669.30	Facility		$2,669.30	$2,669.30	$2,669.30
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $2,669.30 / $2,669.30 / $2,669.30	Professional		$2,669.30	$2,669.30	$2,669.30
Molina Facility/Professional Professional Modifier Low / Median / High Price $1,841.65 / $2,046.28 / $2,250.90	Professional		$1,841.65	$2,046.28	$2,250.90
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $3,721.85 / $4,470.42 / $4,533.89	Facility		$3,721.85	$4,470.42	$4,533.89
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $3,721.85 / $4,470.42 / $4,533.89	Professional		$3,721.85	$4,470.42	$4,533.89
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $233.73 / $233.73 / $233.73	Facility		$233.73	$233.73	$233.73
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $470.01 / $2,528.50 / $4,700.10	Professional		$470.01	$2,528.50	$4,700.10
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $180.24 / $180.24 / $219.46	Professional		$180.24	$180.24	$219.46
United Facility/Professional Professional Modifier Low / Median / High Price $1,046.61 / $1,123.40 / $1,872.33	Professional		$1,046.61	$1,123.40	$1,872.33
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,564.32 / $1,564.32 / $1,564.32	Professional		$1,564.32	$1,564.32	$1,564.32