Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $2,461.75 / $2,791.08 / $4,408.29	Professional		$2,461.75	$2,791.08	$4,408.29
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $489.81 / $5,237.12	Facility		$100.00	$489.81	$5,237.12
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $2,297.63 / $3,535.46 / $5,726.07	Professional		$2,297.63	$3,535.46	$5,726.07
Cigna Facility/Professional Facility Modifier Low / Median / High Price $3,621.85 / $3,621.85 / $3,621.85	Facility		$3,621.85	$3,621.85	$3,621.85
Cigna Facility/Professional Professional Modifier Low / Median / High Price $431.69 / $3,078.57 / $3,780.00	Professional		$431.69	$3,078.57	$3,780.00
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $3,282.33 / $3,282.33 / $3,282.33	Facility		$3,282.33	$3,282.33	$3,282.33
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $3,282.33 / $3,282.33 / $3,282.33	Professional		$3,282.33	$3,282.33	$3,282.33
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $4,128.24 / $4,128.24 / $4,128.24	Facility		$4,128.24	$4,128.24	$4,128.24
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $4,128.24 / $4,128.24 / $4,128.24	Professional		$4,128.24	$4,128.24	$4,128.24
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $489.81 / $489.81 / $489.81	Facility		$489.81	$489.81	$489.81
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $987.35 / $4,063.09 / $5,070.14	Professional		$987.35	$4,063.09	$5,070.14
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $526.78 / $526.78 / $641.41	Professional		$526.78	$526.78	$641.41
United Facility/Professional Professional Modifier Low / Median / High Price $1,852.20 / $2,039.08 / $3,558.00	Professional		$1,852.20	$2,039.08	$3,558.00