Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $2,609.16 / $2,640.90 / $4,122.18	Professional		$2,609.16	$2,640.90	$4,122.18
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $458.02 / $27,719.97 / $27,719.97	Facility		$458.02	$27,719.97	$27,719.97
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $589.72 / $3,893.06 / $5,897.20	Professional		$589.72	$3,893.06	$5,897.20
Cigna Facility/Professional Facility Modifier Low / Median / High Price $3,248.38 / $3,248.38 / $3,248.38	Facility		$3,248.38	$3,248.38	$3,248.38
Cigna Facility/Professional Professional Modifier Low / Median / High Price $453.13 / $2,761.12 / $3,457.08	Professional		$453.13	$2,761.12	$3,457.08
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $5,281.80 / $5,281.80 / $5,281.80	Facility		$5,281.80	$5,281.80	$5,281.80
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $5,281.80 / $5,281.80 / $5,281.80	Professional		$5,281.80	$5,281.80	$5,281.80
Molina Facility/Professional Professional Modifier Low / Median / High Price $487.42 / $4,054.06 / $4,459.46	Professional		$487.42	$4,054.06	$4,459.46
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $5,188.49 / $9,527.53 / $10,492.87	Facility		$5,188.49	$9,527.53	$10,492.87
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $8,613.54 / $10,345.96 / $10,492.87	Professional		$8,613.54	$10,345.96	$10,492.87
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $458.02 / $458.02 / $458.02	Facility		$458.02	$458.02	$458.02
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $923.58 / $4,391.30 / $5,897.20	Professional		$923.58	$4,391.30	$5,897.20
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $357.09 / $357.09 / $434.79	Professional		$357.09	$357.09	$434.79
United Facility/Professional Professional Modifier Low / Median / High Price $2,405.57 / $2,596.26 / $4,992.30	Professional		$2,405.57	$2,596.26	$4,992.30
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $3,769.49 / $3,769.49 / $3,769.49	Professional		$3,769.49	$3,769.49	$3,769.49