Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $2,953.56 / $2,983.65 / $4,666.22	Professional		$2,953.56	$2,983.65	$4,666.22
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $518.47 / $31,412.20 / $31,412.20	Facility		$518.47	$31,412.20	$31,412.20
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $3,313.02 / $4,393.09 / $5,895.53	Professional		$3,313.02	$4,393.09	$5,895.53
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,642.21 / $1,642.21 / $1,642.21	Facility		$1,642.21	$1,642.21	$1,642.21
Cigna Facility/Professional Professional Modifier Low / Median / High Price $513.41 / $1,395.88 / $2,283.77	Professional		$513.41	$1,395.88	$2,283.77
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $5,967.30 / $5,967.30 / $5,967.30	Facility		$5,967.30	$5,967.30	$5,967.30
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $5,967.30 / $5,967.30 / $5,967.30	Professional		$5,967.30	$5,967.30	$5,967.30
Molina Facility/Professional Professional Modifier Low / Median / High Price $550.01 / $3,659.66 / $5,032.03	Professional		$550.01	$3,659.66	$5,032.03
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $5,854.90 / $10,796.56 / $11,890.49	Facility		$5,854.90	$10,796.56	$11,890.49
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $9,760.85 / $11,724.02 / $11,890.49	Professional		$9,760.85	$11,724.02	$11,890.49
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $518.47 / $518.47 / $518.47	Facility		$518.47	$518.47	$518.47
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,045.49 / $4,939.43 / $10,454.91	Professional		$1,045.49	$4,939.43	$10,454.91
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $402.94 / $402.94 / $490.62	Professional		$402.94	$402.94	$490.62
United Facility/Professional Professional Modifier Low / Median / High Price $2,714.54 / $2,938.92 / $5,651.30	Professional		$2,714.54	$2,938.92	$5,651.30
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $4,253.64 / $4,253.64 / $4,253.64	Professional		$4,253.64	$4,253.64	$4,253.64