Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,448.00 / $2,448.00 / $2,448.00	Facility		$2,448.00	$2,448.00	$2,448.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $2,304.00 / $2,448.00 / $2,448.00	Professional		$2,304.00	$2,448.00	$2,448.00
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $2,390.40 / $2,736.00 / $10,800.00	Facility		$2,390.40	$2,736.00	$10,800.00
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $2,448.00 / $10,944.00 / $12,960.00	Professional		$2,448.00	$10,944.00	$12,960.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $396.00 / $396.00 / $396.00	Professional		$396.00	$396.00	$396.00
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 $2,390.40 / $2,390.40 / $2,448.00	Facility		$2,390.40	$2,390.40	$2,448.00
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $2,217.60 / $2,448.00 / $2,592.00	Professional		$2,217.60	$2,448.00	$2,592.00
United Facility/Professional Professional Modifier Low / Median / High Price $2,400.00 / $2,400.00 / $2,880.00	Professional		$2,400.00	$2,400.00	$2,880.00
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $2,040.00 / $2,040.00 / $2,040.00	Professional		$2,040.00	$2,040.00	$2,040.00