Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,354.44 / $1,408.75 / $2,220.48	Professional		$1,354.44	$1,408.75	$2,220.48
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $246.72 / $12,643.10 / $12,643.10	Facility		$246.72	$12,643.10	$12,643.10
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $1,564.36 / $2,074.35 / $3,164.23	Professional		$1,564.36	$2,074.35	$3,164.23
Cigna Facility/Professional Facility Modifier Low / Median / High Price $213.28 / $1,414.26 / $1,414.26	Facility		$213.28	$1,414.26	$1,414.26
Cigna Facility/Professional Professional Modifier Low / Median / High Price $209.10 / $1,202.11 / $1,760.73	Professional		$209.10	$1,202.11	$1,760.73
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $2,817.50 / $2,817.50 / $2,817.50	Facility		$2,817.50	$2,817.50	$2,817.50
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $2,817.50 / $2,817.50 / $2,817.50	Professional		$2,817.50	$2,817.50	$2,817.50
Molina Facility/Professional Professional Modifier Low / Median / High Price $285.47 / $2,160.06 / $2,376.06	Professional		$285.47	$2,160.06	$2,376.06
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $2,291.21 / $4,345.52 / $4,785.81	Facility		$2,291.21	$4,345.52	$4,785.81
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $3,928.65 / $4,718.81 / $4,785.81	Professional		$3,928.65	$4,718.81	$4,785.81
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $246.72 / $246.72 / $246.72	Facility		$246.72	$246.72	$246.72
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $496.13 / $2,516.54 / $3,164.23	Professional		$496.13	$2,516.54	$3,164.23
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $190.26 / $190.26 / $231.66	Professional		$190.26	$190.26	$231.66
United Facility/Professional Professional Modifier Low / Median / High Price $1,194.83 / $1,409.01 / $2,279.50	Professional		$1,194.83	$1,409.01	$2,279.50