Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $8,221.62 / $8,223.45 / $12,961.35	Professional		$8,221.62	$8,223.45	$12,961.35
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $1,440.15 / $11,041.73	Facility		$100.00	$1,440.15	$11,041.73
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $6,913.03 / $9,105.10 / $14,871.68	Professional		$6,913.03	$9,105.10	$14,871.68
Cigna Facility/Professional Facility Modifier Low / Median / High Price $10,102.62 / $10,102.62 / $10,102.62	Facility		$10,102.62	$10,102.62	$10,102.62
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,220.52 / $8,587.24 / $10,102.62	Professional		$1,220.52	$8,587.24	$10,102.62
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $10,964.60 / $10,964.60 / $10,964.60	Facility		$10,964.60	$10,964.60	$10,964.60
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $10,964.60 / $10,964.60 / $10,964.60	Professional		$10,964.60	$10,964.60	$10,964.60
Molina Facility/Professional Professional Modifier Low / Median / High Price $8,131.97 / $9,636.84 / $11,778.36	Professional		$8,131.97	$9,636.84	$11,778.36
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $9,272.19 / $9,272.19 / $9,272.19	Facility		$9,272.19	$9,272.19	$9,272.19
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $9,272.19 / $9,272.19 / $9,272.19	Professional		$9,272.19	$9,272.19	$9,272.19
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,440.15 / $1,440.15 / $1,440.15	Facility		$1,440.15	$1,440.15	$1,440.15
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $2,896.06 / $13,652.19 / $18,470.61	Professional		$2,896.06	$13,652.19	$18,470.61
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $1,110.58 / $1,110.58 / $1,352.24	Professional		$1,110.58	$1,110.58	$1,352.24
United Facility/Professional Professional Modifier Low / Median / High Price $4,298.92 / $4,649.60 / $8,870.79	Professional		$4,298.92	$4,649.60	$8,870.79