Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $2,010.30 / $2,091.25 / $3,296.16	Professional		$2,010.30	$2,091.25	$3,296.16
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $100.00 / $366.24	Facility		$100.00	$100.00	$366.24
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $2,655.46 / $2,733.10 / $4,084.50	Professional		$2,655.46	$2,733.10	$4,084.50
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,569.13 / $2,569.13 / $2,569.13	Facility		$2,569.13	$2,569.13	$2,569.13
Cigna Facility/Professional Professional Modifier Low / Median / High Price $310.38 / $2,183.76 / $4,848.75	Professional		$310.38	$2,183.76	$4,848.75
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $4,182.50 / $4,182.50 / $4,182.50	Facility		$4,182.50	$4,182.50	$4,182.50
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $4,182.50 / $4,182.50 / $4,182.50	Professional		$4,182.50	$4,182.50	$4,182.50
Molina Facility/Professional Professional Modifier Low / Median / High Price $60.00 / $418.25 / $418.25	Professional		$60.00	$418.25	$418.25
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 $366.24 / $366.24 / $366.24	Facility		$366.24	$366.24	$366.24
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $736.49 / $3,471.83 / $4,084.50	Professional		$736.49	$3,471.83	$4,084.50
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $282.42 / $282.42 / $343.87	Professional		$282.42	$282.42	$343.87
United Facility/Professional Professional Modifier Low / Median / High Price $177.36 / $177.36 / $338.39	Professional		$177.36	$177.36	$338.39