Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $5,534.94 / $5,536.20 / $8,725.86	Professional		$5,534.94	$5,536.20	$8,725.86
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $969.54 / $7,433.65	Facility		$100.00	$969.54	$7,433.65
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $1,081.29 / $5,840.67 / $10,011.95	Professional		$1,081.29	$5,840.67	$10,011.95
Cigna Facility/Professional Facility Modifier Low / Median / High Price $3,704.40 / $3,704.40 / $3,704.40	Facility		$3,704.40	$3,704.40	$3,704.40
Cigna Facility/Professional Professional Modifier Low / Median / High Price $821.68 / $3,704.40 / $6,026.06	Professional		$821.68	$3,704.40	$6,026.06
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $7,381.60 / $7,381.60 / $7,381.60	Facility		$7,381.60	$7,381.60	$7,381.60
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $7,381.60 / $7,381.60 / $7,381.60	Professional		$7,381.60	$7,381.60	$7,381.60
Molina Facility/Professional Professional Modifier Low / Median / High Price $5,474.63 / $6,487.74 / $7,929.46	Professional		$5,474.63	$6,487.74	$7,929.46
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $6,242.35 / $6,242.35 / $6,242.35	Facility		$6,242.35	$6,242.35	$6,242.35
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $6,242.35 / $6,242.35 / $6,242.35	Professional		$6,242.35	$6,242.35	$6,242.35
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $969.54 / $969.54 / $969.54	Facility		$969.54	$969.54	$969.54
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,081.29 / $9,889.31 / $12,434.84	Professional		$1,081.29	$9,889.31	$12,434.84
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $747.68 / $747.68 / $910.38	Professional		$747.68	$747.68	$910.38
United Facility/Professional Professional Modifier Low / Median / High Price $2,894.20 / $3,130.20 / $5,972.07	Professional		$2,894.20	$3,130.20	$5,972.07