Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $3,859.86 / $3,887.00 / $6,098.04	Professional		$3,859.86	$3,887.00	$6,098.04
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $6,480.06 / $41,037.44 / $41,037.44	Facility		$6,480.06	$41,037.44	$41,037.44
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $4,316.83 / $5,723.24 / $8,162.70	Professional		$4,316.83	$5,723.24	$8,162.70
Cigna Facility/Professional Facility Modifier Low / Median / High Price $4,775.22 / $4,775.22 / $4,775.22	Facility		$4,775.22	$4,775.22	$4,775.22
Cigna Facility/Professional Professional Modifier Low / Median / High Price $671.53 / $4,058.94 / $5,076.00	Professional		$671.53	$4,058.94	$5,076.00
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $7,774.00 / $7,774.00 / $7,774.00	Facility		$7,774.00	$7,774.00	$7,774.00
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $7,774.00 / $7,774.00 / $7,774.00	Professional		$7,774.00	$7,774.00	$7,774.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $716.53 / $4,767.72 / $6,555.61	Professional		$716.53	$4,767.72	$6,555.61
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $7,627.65 / $14,104.83 / $15,533.95	Facility		$7,627.65	$14,104.83	$15,533.95
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $12,751.75 / $15,316.47 / $15,533.95	Professional		$12,751.75	$15,316.47	$15,533.95
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $677.56 / $677.56 / $677.56	Facility		$677.56	$677.56	$677.56
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $6,453.03 / $7,016.13 / $7,754.67	Professional		$6,453.03	$7,016.13	$7,754.67
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $524.94 / $524.94 / $639.16	Professional		$524.94	$524.94	$639.16
United Facility/Professional Professional Modifier Low / Median / High Price $3,536.46 / $3,840.72 / $7,385.40	Professional		$3,536.46	$3,840.72	$7,385.40