Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,202.64 / $2,202.64 / $5,182.68	Facility		$2,202.64	$2,202.64	$5,182.68
Aetna Facility/Professional Professional Modifier Low / Median / High Price $2,150.81 / $2,202.64 / $2,202.64	Professional		$2,150.81	$2,202.64	$2,202.64
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $1,910.69 / $2,866.04 / $5,923.14	Facility		$1,910.69	$2,866.04	$5,923.14
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $636.82 / $636.82 / $2,479.75	Professional		$636.82	$636.82	$2,479.75
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,202.64 / $4,405.28 / $6,925.76	Facility		$2,202.64	$4,405.28	$6,925.76
Cigna Facility/Professional Professional Modifier Low / Median / High Price $2,202.64 / $2,202.64 / $2,202.64	Professional		$2,202.64	$2,202.64	$2,202.64
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $50.00 / $50.00	Professional		$50.00	$50.00	$50.00
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $957.55 / $1,150.14 / $1,166.47	Facility		$957.55	$1,150.14	$1,166.47
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,719.62 / $3,057.10 / $5,349.93	Facility		$1,719.62	$3,057.10	$5,349.93
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,909.41 / $2,231.78 / $2,479.75	Professional		$1,909.41	$2,231.78	$2,479.75
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $1,504.96 / $2,292.83 / $4,450.07	Facility		$1,504.96	$2,292.83	$4,450.07
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $636.82 / $636.82 / $636.82	Professional		$636.82	$636.82	$636.82
United Facility/Professional Professional Modifier Low / Median / High Price $2,159.44 / $2,159.44 / $2,159.44	Professional		$2,159.44	$2,159.44	$2,159.44