Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $897.70 / $901.44 / $1,424.07	Professional		$897.70	$901.44	$1,424.07
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $158.22 / $9,825.29 / $9,825.29	Facility		$158.22	$9,825.29	$9,825.29
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $1,000.00 / $1,408.80 / $2,309.63	Professional		$1,000.00	$1,408.80	$2,309.63
Cigna Facility/Professional Facility Modifier Low / Median / High Price $504.00 / $504.00 / $504.00	Facility		$504.00	$504.00	$504.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $154.43 / $428.40 / $1,126.17	Professional		$154.43	$428.40	$1,126.17
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,795.40 / $1,795.40 / $1,795.40	Facility		$1,795.40	$1,795.40	$1,795.40
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,795.40 / $1,795.40 / $1,795.40	Professional		$1,795.40	$1,795.40	$1,795.40
Molina Facility/Professional Professional Modifier Low / Median / High Price $1,320.47 / $1,467.19 / $1,613.90	Professional		$1,320.47	$1,467.19	$1,613.90
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,877.59 / $2,197.25 / $2,676.65	Facility		$1,877.59	$2,197.25	$2,676.65
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $2,197.25 / $2,676.65 / $2,676.65	Professional		$2,197.25	$2,676.65	$2,676.65
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $158.22 / $158.22 / $158.22	Facility		$158.22	$158.22	$158.22
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $319.05 / $1,810.83 / $3,190.51	Professional		$319.05	$1,810.83	$3,190.51
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $129.22 / $129.22 / $157.35	Professional		$129.22	$129.22	$157.35
United Facility/Professional Professional Modifier Low / Median / High Price $897.00 / $1,222.15 / $1,724.60	Professional		$897.00	$1,222.15	$1,724.60