Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $4,984.85 / $4,993.14 / $7,888.23	Professional		$4,984.85	$4,993.14	$7,888.23
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $876.47 / $54,554.97 / $54,554.97	Facility		$876.47	$54,554.97	$54,554.97
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $5,844.83 / $7,750.19 / $11,131.19	Professional		$5,844.83	$7,750.19	$11,131.19
Cigna Facility/Professional Facility Modifier Low / Median / High Price $4,933.43 / $4,933.43 / $4,933.43	Facility		$4,933.43	$4,933.43	$4,933.43
Cigna Facility/Professional Professional Modifier Low / Median / High Price $4,193.42 / $4,933.43 / $6,372.00	Professional		$4,193.42	$4,933.43	$6,372.00
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $9,969.70 / $9,969.70 / $9,969.70	Facility		$9,969.70	$9,969.70	$9,969.70
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $9,969.70 / $9,969.70 / $9,969.70	Professional		$9,969.70	$9,969.70	$9,969.70
Molina Facility/Professional Professional Modifier Low / Median / High Price $970.32 / $6,456.39 / $8,877.53	Professional		$970.32	$6,456.39	$8,877.53
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $10,329.04 / $12,202.30 / $14,864.62	Facility		$10,329.04	$12,202.30	$14,864.62
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $12,202.30 / $14,864.62 / $14,864.62	Professional		$12,202.30	$14,864.62	$14,864.62
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $876.47 / $876.47 / $876.47	Facility		$876.47	$876.47	$876.47
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $8,227.41 / $9,679.29 / $10,030.76	Professional		$8,227.41	$9,679.29	$10,030.76
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $710.87 / $710.87 / $865.56	Professional		$710.87	$710.87	$865.56
United Facility/Professional Facility Modifier Low / Median / High Price $438.98 / $3,726.45 / $6,668.40	Facility		$438.98	$3,726.45	$6,668.40
United Facility/Professional Professional Modifier Low / Median / High Price $4,788.92 / $4,968.60 / $9,553.10	Professional		$4,788.92	$4,968.60	$9,553.10