Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,214.63 / $2,004.13 / $3,464.00	Facility		$1,214.63	$2,004.13	$3,464.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,119.54 / $1,276.80 / $3,735.00	Professional		$1,119.54	$1,276.80	$3,735.00
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $1,238.93 / $2,379.67 / $4,627.14	Facility		$1,238.93	$2,379.67	$4,627.14
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $1,238.93 / $1,238.93 / $1,457.56	Professional		$1,238.93	$1,238.93	$1,457.56
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,238.93 / $1,238.93 / $3,708.60	Facility		$1,238.93	$1,238.93	$3,708.60
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,238.93 / $1,238.93 / $1,238.93	Professional		$1,238.93	$1,238.93	$1,238.93
Molina Facility/Professional Professional Modifier Low / Median / High Price $1,214.63 / $1,214.63 / $3,036.57	Professional		$1,214.63	$1,214.63	$3,036.57
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $79,999.20 / $79,999.20 / $79,999.20	Facility		$79,999.20	$79,999.20	$79,999.20
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,238.93 / $2,379.67 / $3,635.61	Facility		$1,238.93	$2,379.67	$3,635.61
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,122.32 / $1,311.80 / $1,457.56	Professional		$1,122.32	$1,311.80	$1,457.56
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $1,238.93 / $1,238.93 / $1,238.93	Facility		$1,238.93	$1,238.93	$1,238.93
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $1,238.93 / $1,238.93 / $1,238.93	Professional		$1,238.93	$1,238.93	$1,238.93
United Facility/Professional Professional Modifier Low / Median / High Price $1,214.63 / $1,214.63 / $1,214.63	Professional		$1,214.63	$1,214.63	$1,214.63