Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $3,979.26 / $5,130.06 / $8,087.58	Professional		$3,979.26	$5,130.06	$8,087.58
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $6,889.88 / $6,889.88	Facility		$100.00	$6,889.88	$6,889.88
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $4,313.63 / $8,456.90 / $10,022.00	Professional		$4,313.63	$8,456.90	$10,022.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $4,488.00 / $4,978.93 / $4,978.93	Facility		$4,488.00	$4,978.93	$4,978.93
Cigna Facility/Professional Professional Modifier Low / Median / High Price $4,232.09 / $4,232.09 / $11,898.75	Professional		$4,232.09	$4,232.09	$11,898.75
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $6,841.67 / $6,841.67 / $6,841.67	Facility		$6,841.67	$6,841.67	$6,841.67
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $6,841.67 / $6,841.67 / $6,841.67	Professional		$6,841.67	$6,841.67	$6,841.67
Molina Facility/Professional Professional Modifier Low / Median / High Price $4,510.34 / $6,013.19 / $7,349.46	Professional		$4,510.34	$6,013.19	$7,349.46
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $5,785.71 / $5,785.71 / $5,785.71	Facility		$5,785.71	$5,785.71	$5,785.71
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $5,785.71 / $5,785.71 / $5,785.71	Professional		$5,785.71	$5,785.71	$5,785.71
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $898.62 / $898.62 / $898.62	Facility		$898.62	$898.62	$898.62
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $5,681.40 / $8,518.70 / $18,070.80	Professional		$5,681.40	$8,518.70	$18,070.80
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $692.98 / $692.98 / $843.77	Professional		$692.98	$692.98	$843.77
United Facility/Professional Professional Modifier Low / Median / High Price $2,901.24 / $3,384.78 / $5,535.20	Professional		$2,901.24	$3,384.78	$5,535.20