Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $3,062.82 / $3,062.82 / $3,062.82	Facility		$3,062.82	$3,062.82	$3,062.82
Aetna Facility/Professional Professional Modifier Low / Median / High Price $2,784.38 / $2,812.22 / $3,062.82	Professional		$2,784.38	$2,812.22	$3,062.82
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $210.07 / $240.00 / $2,784.38	Facility		$210.07	$240.00	$2,784.38
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $137.13 / $2,784.38 / $2,784.38	Professional		$137.13	$2,784.38	$2,784.38
Cigna Facility/Professional Facility Modifier Low / Median / High Price $185.30 / $2,626.77 / $2,784.38	Facility		$185.30	$2,626.77	$2,784.38
Cigna Facility/Professional Professional Modifier Low / Median / High Price $2,784.38 / $2,784.38 / $3,414.80	Professional		$2,784.38	$2,784.38	$3,414.80
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $242.08 / $2,784.38 / $3,480.48	Facility		$242.08	$2,784.38	$3,480.48
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $242.08 / $2,784.38 / $3,480.48	Professional		$242.08	$2,784.38	$3,480.48
Molina Facility/Professional Professional Modifier Low / Median / High Price $30.00 / $75.00 / $75.00	Professional		$30.00	$75.00	$75.00
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $530.00 / $2,784.38 / $8,353.14	Facility		$530.00	$2,784.38	$8,353.14
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $141.78 / $210.07 / $210.07	Facility		$141.78	$210.07	$210.07
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $101.90 / $115.19 / $181.65	Professional		$101.90	$115.19	$181.65
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $2,784.38 / $2,784.38 / $2,784.38	Facility		$2,784.38	$2,784.38	$2,784.38
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $2,645.16 / $2,784.38 / $2,784.38	Professional		$2,645.16	$2,784.38	$2,784.38
United Facility/Professional Professional Modifier Low / Median / High Price $2,784.38 / $2,784.38 / $3,341.26	Professional		$2,784.38	$2,784.38	$3,341.26
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $93.93 / $2,784.38 / $2,784.38	Professional		$93.93	$2,784.38	$2,784.38