Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $3,577.92 / $3,578.75 / $5,640.39	Professional		$3,577.92	$3,578.75	$5,640.39
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $258.22 / $33,203.46 / $33,203.46	Facility		$258.22	$33,203.46	$33,203.46
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $4,659.21 / $5,035.12 / $7,873.25	Professional		$4,659.21	$5,035.12	$7,873.25
Cigna Facility/Professional Facility Modifier Low / Median / High Price $5,106.14 / $5,106.14 / $5,106.14	Facility		$5,106.14	$5,106.14	$5,106.14
Cigna Facility/Professional Professional Modifier Low / Median / High Price $616.89 / $4,340.22 / $5,106.14	Professional		$616.89	$4,340.22	$5,106.14
Molina Facility/Professional Professional Modifier Low / Median / High Price $60.00 / $715.75 / $5,546.50	Professional		$60.00	$715.75	$5,546.50
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $5,681.50 / $11,412.23 / $12,568.53	Facility		$5,681.50	$11,412.23	$12,568.53
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $10,317.45 / $12,392.57 / $12,568.53	Professional		$10,317.45	$12,392.57	$12,568.53
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $626.73 / $626.73 / $626.73	Facility		$626.73	$626.73	$626.73
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $5,941.25 / $7,153.23 / $12,603.31	Professional		$5,941.25	$7,153.23	$12,603.31
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $483.31 / $483.31 / $588.48	Professional		$483.31	$483.31	$588.48
United Facility/Professional Professional Modifier Low / Median / High Price $2,091.96 / $2,326.48 / $3,991.27	Professional		$2,091.96	$2,326.48	$3,991.27
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $4,969.71 / $4,969.71 / $4,969.71	Professional		$4,969.71	$4,969.71	$4,969.71