Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,562.88 / $1,572.90 / $2,469.15	Professional		$1,562.88	$1,572.90	$2,469.15
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $274.35 / $16,606.15 / $16,606.15	Facility		$274.35	$16,606.15	$16,606.15
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $1,746.58 / $2,315.98 / $3,552.26	Professional		$1,746.58	$2,315.98	$3,552.26
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,850.09 / $1,850.09 / $1,850.09	Facility		$1,850.09	$1,850.09	$1,850.09
Cigna Facility/Professional Professional Modifier Low / Median / High Price $271.95 / $1,572.58 / $3,648.75	Professional		$271.95	$1,572.58	$3,648.75
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $3,145.80 / $3,145.80 / $3,145.80	Facility		$3,145.80	$3,145.80	$3,145.80
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $3,145.80 / $3,145.80 / $3,145.80	Professional		$3,145.80	$3,145.80	$3,145.80
Molina Facility/Professional Professional Modifier Low / Median / High Price $1,929.30 / $2,411.63 / $2,652.79	Professional		$1,929.30	$2,411.63	$2,652.79
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $3,086.64 / $5,707.63 / $6,285.94	Facility		$3,086.64	$5,707.63	$6,285.94
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $5,160.10 / $6,197.94 / $6,285.94	Professional		$5,160.10	$6,197.94	$6,285.94
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $274.35 / $274.35 / $274.35	Facility		$274.35	$274.35	$274.35
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $2,612.38 / $2,798.37 / $3,072.10	Professional		$2,612.38	$2,798.37	$3,072.10
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $212.42 / $212.42 / $258.64	Professional		$212.42	$212.42	$258.64
United Facility/Professional Professional Modifier Low / Median / High Price $1,555.14 / $1,873.91 / $2,990.40	Professional		$1,555.14	$1,873.91	$2,990.40
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $2,242.46 / $2,242.46 / $2,242.46	Professional		$2,242.46	$2,242.46	$2,242.46