Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $3,727.70 / $4,033.92 / $6,460.92	Professional		$3,727.70	$4,033.92	$6,460.92
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $708.03 / $6,464.83	Facility		$100.00	$708.03	$6,464.83
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $3,502.87 / $4,328.37 / $9,904.40	Professional		$3,502.87	$4,328.37	$9,904.40
Cigna Facility/Professional Facility Modifier Low / Median / High Price $5,587.01 / $5,587.01 / $5,587.01	Facility		$5,587.01	$5,587.01	$5,587.01
Cigna Facility/Professional Professional Modifier Low / Median / High Price $665.31 / $4,748.96 / $5,587.01	Professional		$665.31	$4,748.96	$5,587.01
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $5,115.67 / $5,115.67 / $5,115.67	Facility		$5,115.67	$5,115.67	$5,115.67
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $5,115.67 / $5,115.67 / $5,115.67	Professional		$5,115.67	$5,115.67	$5,115.67
Molina Facility/Professional Professional Modifier Low / Median / High Price $3,692.45 / $4,513.00 / $6,430.67	Professional		$3,692.45	$4,513.00	$6,430.67
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 $708.03 / $708.03 / $708.03	Facility		$708.03	$708.03	$708.03
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $4,328.37 / $6,332.50 / $14,274.79	Professional		$4,328.37	$6,332.50	$14,274.79
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $650.23 / $650.23 / $791.72	Professional		$650.23	$650.23	$791.72
United Facility/Professional Professional Modifier Low / Median / High Price $2,487.88 / $2,517.00 / $4,780.60	Professional		$2,487.88	$2,517.00	$4,780.60
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $6,354.63 / $6,354.63 / $6,354.63	Professional		$6,354.63	$6,354.63	$6,354.63