Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,493.70 / $1,494.00 / $2,354.85	Professional		$1,493.70	$1,494.00	$2,354.85
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $261.64 / $13,407.77 / $13,407.77	Facility		$261.64	$13,407.77	$13,407.77
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $1,658.76 / $2,199.53 / $3,137.40	Professional		$1,658.76	$2,199.53	$3,137.40
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,219.64 / $1,219.64 / $1,219.64	Facility		$1,219.64	$1,219.64	$1,219.64
Cigna Facility/Professional Professional Modifier Low / Median / High Price $221.74 / $1,036.69 / $1,944.00	Professional		$221.74	$1,036.69	$1,944.00
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $2,988.00 / $2,988.00 / $2,988.00	Facility		$2,988.00	$2,988.00	$2,988.00
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $2,988.00 / $2,988.00 / $2,988.00	Professional		$2,988.00	$2,988.00	$2,988.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $262.62 / $320.98 / $3,209.80	Professional		$262.62	$320.98	$3,209.80
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $2,526.60 / $4,608.33 / $5,075.25	Facility		$2,526.60	$4,608.33	$5,075.25
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $4,166.25 / $5,004.20 / $5,075.25	Professional		$4,166.25	$5,004.20	$5,075.25
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $261.64 / $261.64 / $261.64	Facility		$261.64	$261.64	$261.64
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $2,480.30 / $2,918.00 / $5,261.59	Professional		$2,480.30	$2,918.00	$5,261.59
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $201.76 / $201.76 / $245.66	Professional		$201.76	$201.76	$245.66
United Facility/Professional Professional Modifier Low / Median / High Price $1,171.42 / $1,257.65 / $2,096.08	Professional		$1,171.42	$1,257.65	$2,096.08
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,835.61 / $1,835.61 / $1,835.61	Professional		$1,835.61	$1,835.61	$1,835.61