Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,547.52 / $1,547.85 / $2,439.63	Professional		$1,547.52	$1,547.85	$2,439.63
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $271.07 / $13,890.95 / $13,890.95	Facility		$271.07	$13,890.95	$13,890.95
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $1,718.74 / $2,279.06 / $3,250.49	Professional		$1,718.74	$2,279.06	$3,250.49
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,406.76 / $1,406.76 / $1,406.76	Facility		$1,406.76	$1,406.76	$1,406.76
Cigna Facility/Professional Professional Modifier Low / Median / High Price $229.74 / $1,195.75 / $1,917.00	Professional		$229.74	$1,195.75	$1,917.00
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $3,095.70 / $3,095.70 / $3,095.70	Facility		$3,095.70	$3,095.70	$3,095.70
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $3,095.70 / $3,095.70 / $3,095.70	Professional		$3,095.70	$3,095.70	$3,095.70
Molina Facility/Professional Professional Modifier Low / Median / High Price $272.07 / $332.54 / $3,325.41	Professional		$272.07	$332.54	$3,325.41
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $2,617.96 / $4,774.41 / $5,258.16	Facility		$2,617.96	$4,774.41	$5,258.16
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $4,316.39 / $5,184.55 / $5,258.16	Professional		$4,316.39	$5,184.55	$5,258.16
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $271.07 / $271.07 / $271.07	Facility		$271.07	$271.07	$271.07
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $545.10 / $2,569.64 / $3,476.56	Professional		$545.10	$2,569.64	$3,476.56
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $209.04 / $209.04 / $254.53	Professional		$209.04	$209.04	$254.53
United Facility/Professional Professional Modifier Low / Median / High Price $1,213.78 / $1,302.91 / $2,171.51	Professional		$1,213.78	$1,302.91	$2,171.51
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,901.98 / $1,901.98 / $1,901.98	Professional		$1,901.98	$1,901.98	$1,901.98