Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $4,096.85 / $4,096.85 / $9,639.64	Facility		$4,096.85	$4,096.85	$9,639.64
Aetna Facility/Professional Professional Modifier Low / Median / High Price $3,855.86 / $4,096.85 / $4,096.85	Professional		$3,855.86	$4,096.85	$4,096.85
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $5,301.80 / $5,301.80 / $5,301.80	Facility		$5,301.80	$5,301.80	$5,301.80
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $4,717.72 / $6,584.84 / $21,887.34	Professional		$4,717.72	$6,584.84	$21,887.34
Cigna Facility/Professional Facility Modifier Low / Median / High Price $4,819.82 / $4,819.82 / $9,639.64	Facility		$4,819.82	$4,819.82	$9,639.64
Cigna Facility/Professional Professional Modifier Low / Median / High Price $4,819.82 / $4,819.82 / $5,911.10	Professional		$4,819.82	$4,819.82	$5,911.10
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,541.59 / $4,819.82 / $9,821.28	Facility		$1,541.59	$4,819.82	$9,821.28
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $4,819.82 / $4,819.82 / $8,916.67	Professional		$4,819.82	$4,819.82	$8,916.67
Molina Facility/Professional Professional Modifier Low / Median / High Price $70.00 / $5,252.01 / $5,729.47	Professional		$70.00	$5,252.01	$5,729.47
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $4,819.82 / $4,819.82 / $4,819.82	Facility		$4,819.82	$4,819.82	$4,819.82
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $4,819.82 / $4,819.82 / $5,301.80	Facility		$4,819.82	$4,819.82	$5,301.80
United Facility/Professional Professional Modifier Low / Median / High Price $5,684.00 / $5,684.00 / $6,820.80	Professional		$5,684.00	$5,684.00	$6,820.80
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $4,819.82 / $4,819.82 / $4,819.82	Professional		$4,819.82	$4,819.82	$4,819.82