Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $2,805.95 / $3,163.26 / $4,996.17	Professional		$2,805.95	$3,163.26	$4,996.17
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $555.13 / $5,872.68	Facility		$100.00	$555.13	$5,872.68
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $2,618.88 / $4,029.79 / $7,407.71	Professional		$2,618.88	$4,029.79	$7,407.71
Cigna Facility/Professional Facility Modifier Low / Median / High Price $4,124.25 / $4,124.25 / $4,124.25	Facility		$4,124.25	$4,124.25	$4,124.25
Cigna Facility/Professional Professional Modifier Low / Median / High Price $491.56 / $3,505.61 / $4,276.80	Professional		$491.56	$3,505.61	$4,276.80
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $3,741.27 / $3,741.27 / $3,741.27	Facility		$3,741.27	$3,741.27	$3,741.27
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $3,741.27 / $3,741.27 / $3,741.27	Professional		$3,741.27	$3,741.27	$3,741.27
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $4,629.09 / $4,629.09 / $4,629.09	Facility		$4,629.09	$4,629.09	$4,629.09
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $4,629.09 / $4,629.09 / $4,629.09	Professional		$4,629.09	$4,629.09	$4,629.09
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $555.13 / $555.13 / $555.13	Facility		$555.13	$555.13	$555.13
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $4,358.43 / $5,448.50 / $5,746.36	Professional		$4,358.43	$5,448.50	$5,746.36
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $590.67 / $590.67 / $719.21	Professional		$590.67	$590.67	$719.21
United Facility/Professional Professional Modifier Low / Median / High Price $2,099.16 / $2,236.76 / $4,032.53	Professional		$2,099.16	$2,236.76	$4,032.53