Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $759.95 / $1,347.30 / $2,124.00	Professional		$759.95	$1,347.30	$2,124.00
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $236.00 / $12,092.66 / $12,092.66	Facility		$236.00	$12,092.66	$12,092.66
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $1,496.28 / $1,984.08 / $2,829.96	Professional		$1,496.28	$1,984.08	$2,829.96
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,208.78 / $1,208.78 / $1,208.78	Facility		$1,208.78	$1,208.78	$1,208.78
Cigna Facility/Professional Professional Modifier Low / Median / High Price $200.01 / $1,027.46 / $1,890.00	Professional		$200.01	$1,027.46	$1,890.00
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $2,695.20 / $2,695.20 / $2,695.20	Facility		$2,695.20	$2,695.20	$2,695.20
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $2,695.20 / $2,695.20 / $2,695.20	Professional		$2,695.20	$2,695.20	$2,695.20
Molina Facility/Professional Professional Modifier Low / Median / High Price $236.88 / $289.52 / $2,895.20	Professional		$236.88	$289.52	$2,895.20
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $2,279.13 / $4,156.32 / $4,577.43	Facility		$2,279.13	$4,156.32	$4,577.43
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $3,757.60 / $4,513.35 / $4,577.43	Professional		$3,757.60	$4,513.35	$4,577.43
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $236.00 / $236.00 / $236.00	Facility		$236.00	$236.00	$236.00
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,928.95 / $2,407.19 / $3,026.80	Professional		$1,928.95	$2,407.19	$3,026.80
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $182.00 / $182.00 / $221.60	Professional		$182.00	$182.00	$221.60
United Facility/Professional Professional Modifier Low / Median / High Price $1,056.68 / $1,134.22 / $1,890.37	Professional		$1,056.68	$1,134.22	$1,890.37
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,655.81 / $1,655.81 / $1,655.81	Professional		$1,655.81	$1,655.81	$1,655.81