Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,870.00 / $1,870.00 / $1,870.00	Facility		$1,870.00	$1,870.00	$1,870.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,760.00 / $1,870.00 / $1,870.00	Professional		$1,760.00	$1,870.00	$1,870.00
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $1,826.00 / $2,346.25 / $8,250.00	Facility		$1,826.00	$2,346.25	$8,250.00
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $1,870.00 / $8,360.00 / $9,900.00	Professional		$1,870.00	$8,360.00	$9,900.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,870.00 / $1,870.00 / $7,977.24	Facility		$1,870.00	$1,870.00	$7,977.24
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,870.00 / $1,870.00 / $1,870.00	Professional		$1,870.00	$1,870.00	$1,870.00
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $12.82 / $12.82 / $12.82	Professional		$12.82	$12.82	$12.82
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $50.00 / $75.00	Professional		$50.00	$50.00	$75.00
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $79,999.20 / $79,999.20 / $79,999.20	Facility		$79,999.20	$79,999.20	$79,999.20
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,826.00 / $1,826.00 / $1,870.00	Facility		$1,826.00	$1,826.00	$1,870.00
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,694.00 / $1,870.00 / $1,980.00	Professional		$1,694.00	$1,870.00	$1,980.00
United Facility/Professional Professional Modifier Low / Median / High Price $2,200.00 / $2,200.00 / $2,640.00	Professional		$2,200.00	$2,200.00	$2,640.00
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,496.00 / $1,496.00 / $1,496.00	Professional		$1,496.00	$1,496.00	$1,496.00