Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $5,321.94 / $5,323.15 / $8,390.07	Professional		$5,321.94	$5,323.15	$8,390.07
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $932.23 / $7,147.29	Facility		$100.00	$932.23	$7,147.29
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $4,474.79 / $6,997.66 / $10,396.79	Professional		$4,474.79	$6,997.66	$10,396.79
Cigna Facility/Professional Facility Modifier Low / Median / High Price $6,539.60 / $6,539.60 / $6,539.60	Facility		$6,539.60	$6,539.60	$6,539.60
Cigna Facility/Professional Professional Modifier Low / Median / High Price $790.06 / $5,558.66 / $6,539.60	Professional		$790.06	$5,558.66	$6,539.60
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $7,097.53 / $7,097.53 / $7,097.53	Facility		$7,097.53	$7,097.53	$7,097.53
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $7,097.53 / $7,097.53 / $7,097.53	Professional		$7,097.53	$7,097.53	$7,097.53
Molina Facility/Professional Professional Modifier Low / Median / High Price $5,263.92 / $6,238.08 / $7,624.32	Professional		$5,263.92	$6,238.08	$7,624.32
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $6,001.96 / $6,001.96 / $6,001.96	Facility		$6,001.96	$6,001.96	$6,001.96
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $6,001.96 / $6,001.96 / $6,001.96	Professional		$6,001.96	$6,001.96	$6,001.96
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $932.23 / $932.23 / $932.23	Facility		$932.23	$932.23	$932.23
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $8,837.28 / $10,396.79 / $11,956.32	Professional		$8,837.28	$10,396.79	$11,956.32
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $718.89 / $718.89 / $875.32	Professional		$718.89	$718.89	$875.32
United Facility/Professional Professional Modifier Low / Median / High Price $2,782.72 / $3,009.76 / $5,742.20	Professional		$2,782.72	$3,009.76	$5,742.20