Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $2,045.76 / $2,060.44 / $3,232.08	Professional		$2,045.76	$2,060.44	$3,232.08
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $359.12 / $21,753.30 / $21,753.30	Facility		$359.12	$21,753.30	$21,753.30
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $2,287.94 / $3,033.82 / $4,627.95	Professional		$2,287.94	$3,033.82	$4,627.95
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,399.94 / $2,399.94 / $2,399.94	Facility		$2,399.94	$2,399.94	$2,399.94
Cigna Facility/Professional Professional Modifier Low / Median / High Price $355.90 / $2,039.95 / $2,697.57	Professional		$355.90	$2,039.95	$2,697.57
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $4,120.89 / $4,120.89 / $4,120.89	Facility		$4,120.89	$4,120.89	$4,120.89
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $4,120.89 / $4,120.89 / $4,120.89	Professional		$4,120.89	$4,120.89	$4,120.89
Molina Facility/Professional Professional Modifier Low / Median / High Price $379.82 / $2,527.29 / $3,475.03	Professional		$379.82	$2,527.29	$3,475.03
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $4,043.33 / $7,476.74 / $8,234.29	Facility		$4,043.33	$7,476.74	$8,234.29
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $6,759.50 / $8,119.02 / $8,234.29	Professional		$6,759.50	$8,119.02	$8,234.29
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $359.12 / $359.12 / $359.12	Facility		$359.12	$359.12	$359.12
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $724.15 / $3,663.02 / $4,627.95	Professional		$724.15	$3,663.02	$4,627.95
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $278.26 / $278.26 / $338.81	Professional		$278.26	$278.26	$338.81
United Facility/Professional Professional Modifier Low / Median / High Price $1,874.63 / $2,035.62 / $3,914.30	Professional		$1,874.63	$2,035.62	$3,914.30
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $2,937.52 / $2,937.52 / $2,937.52	Professional		$2,937.52	$2,937.52	$2,937.52