Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $9,078.66 / $9,080.70 / $14,312.52	Professional		$9,078.66	$9,080.70	$14,312.52
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $1,590.28 / $12,192.66	Facility		$100.00	$1,590.28	$12,192.66
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $7,633.61 / $13,370.01 / $17,735.70	Professional		$7,633.61	$13,370.01	$17,735.70
Cigna Facility/Professional Facility Modifier Low / Median / High Price $11,155.72 / $11,155.72 / $11,155.72	Facility		$11,155.72	$11,155.72	$11,155.72
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,347.76 / $9,482.36 / $11,155.72	Professional		$1,347.76	$9,482.36	$11,155.72
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $12,107.60 / $12,107.60 / $12,107.60	Facility		$12,107.60	$12,107.60	$12,107.60
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $12,107.60 / $12,107.60 / $12,107.60	Professional		$12,107.60	$12,107.60	$12,107.60
Molina Facility/Professional Professional Modifier Low / Median / High Price $8,979.72 / $10,641.42 / $13,006.18	Professional		$8,979.72	$10,641.42	$13,006.18
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $10,238.79 / $10,238.79 / $10,238.79	Facility		$10,238.79	$10,238.79	$10,238.79
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $10,238.79 / $10,238.79 / $10,238.79	Professional		$10,238.79	$10,238.79	$10,238.79
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,590.28 / $1,590.28 / $1,590.28	Facility		$1,590.28	$1,590.28	$1,590.28
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $3,197.97 / $15,075.35 / $31,979.66	Professional		$3,197.97	$15,075.35	$31,979.66
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $1,226.34 / $1,226.34 / $1,493.20	Professional		$1,226.34	$1,226.34	$1,493.20
United Facility/Professional Professional Modifier Low / Median / High Price $4,747.08 / $5,134.32 / $9,795.60	Professional		$4,747.08	$5,134.32	$9,795.60