Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $933.40 / $1,340.10 / $2,117.16	Professional		$933.40	$1,340.10	$2,117.16
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $235.24 / $14,590.13 / $14,590.13	Facility		$235.24	$14,590.13	$14,590.13
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $1,579.34 / $2,100.40 / $2,768.10	Professional		$1,579.34	$2,100.40	$2,768.10
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,350.00 / $1,350.00 / $1,377.00	Facility		$1,350.00	$1,350.00	$1,377.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,147.50 / $1,350.00 / $1,833.30	Professional		$1,147.50	$1,350.00	$1,833.30
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $2,666.40 / $2,666.40 / $2,666.40	Facility		$2,666.40	$2,666.40	$2,666.40
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $2,666.40 / $2,666.40 / $2,666.40	Professional		$2,666.40	$2,666.40	$2,666.40
Molina Facility/Professional Professional Modifier Low / Median / High Price $262.99 / $1,749.81 / $2,405.99	Professional		$262.99	$1,749.81	$2,405.99
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $2,799.29 / $3,263.70 / $3,975.78	Facility		$2,799.29	$3,263.70	$3,975.78
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $3,263.70 / $3,975.78 / $3,975.78	Professional		$3,263.70	$3,975.78	$3,975.78
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $235.24 / $235.24 / $235.24	Facility		$235.24	$235.24	$235.24
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $474.32 / $2,200.48 / $2,511.14	Professional		$474.32	$2,200.48	$2,511.14
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $192.66 / $192.66 / $234.58	Professional		$192.66	$192.66	$234.58
United Facility/Professional Professional Modifier Low / Median / High Price $1,297.84 / $1,333.56 / $2,563.90	Professional		$1,297.84	$1,333.56	$2,563.90