Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $3,443.84 / $4,900.80 / $7,742.25	Professional		$3,443.84	$4,900.80	$7,742.25
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $8,774.26 / $53,184.97 / $53,184.97	Facility		$8,774.26	$53,184.97	$53,184.97
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $5,757.34 / $7,749.48 / $10,154.00	Professional		$5,757.34	$7,749.48	$10,154.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $5,900.00 / $5,900.00 / $6,018.00	Facility		$5,900.00	$5,900.00	$6,018.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $5,015.00 / $5,900.00 / $8,590.32	Professional		$5,015.00	$5,900.00	$8,590.32
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $9,719.60 / $9,719.60 / $9,719.60	Facility		$9,719.60	$9,719.60	$9,719.60
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $9,719.60 / $9,719.60 / $9,719.60	Professional		$9,719.60	$9,719.60	$9,719.60
Molina Facility/Professional Professional Modifier Low / Median / High Price $726.29 / $970.24 / $8,069.91	Professional		$726.29	$970.24	$8,069.91
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $10,328.12 / $11,895.95 / $14,491.43	Facility		$10,328.12	$11,895.95	$14,491.43
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $11,895.95 / $14,491.43 / $14,491.43	Professional		$11,895.95	$14,491.43	$14,491.43
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $860.25 / $860.25 / $860.25	Facility		$860.25	$860.25	$860.25
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $8,741.27 / $9,153.41 / $9,436.50	Professional		$8,741.27	$9,153.41	$9,436.50
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $710.82 / $710.82 / $865.49	Professional		$710.82	$710.82	$865.49
United Facility/Professional Professional Modifier Low / Median / High Price $4,788.50 / $4,876.80 / $9,376.10	Professional		$4,788.50	$4,876.80	$9,376.10