Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $4,105.50 / $4,105.50 / $4,105.50	Facility		$4,105.50	$4,105.50	$4,105.50
Aetna Facility/Professional Professional Modifier Low / Median / High Price $3,864.00 / $4,105.50 / $4,105.50	Professional		$3,864.00	$4,105.50	$4,105.50
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $4,008.90 / $4,830.00 / $18,112.50	Facility		$4,008.90	$4,830.00	$18,112.50
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $2,968.00 / $16,905.00 / $21,735.00	Professional		$2,968.00	$16,905.00	$21,735.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $4,105.50 / $4,105.50 / $8,211.00	Facility		$4,105.50	$4,105.50	$8,211.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $4,105.50 / $4,105.50 / $4,105.50	Professional		$4,105.50	$4,105.50	$4,105.50
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $7,449.68 / $7,449.68 / $7,449.68	Professional		$7,449.68	$7,449.68	$7,449.68
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $75.00 / $75.00	Professional		$50.00	$75.00	$75.00
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $4,748.80 / $79,999.20 / $79,999.20	Facility		$4,748.80	$79,999.20	$79,999.20
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $4,008.90 / $4,008.90 / $4,105.50	Facility		$4,008.90	$4,008.90	$4,105.50
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $3,719.10 / $4,105.50 / $4,347.00	Professional		$3,719.10	$4,105.50	$4,347.00
United Facility/Professional Professional Modifier Low / Median / High Price $4,200.00 / $4,200.00 / $5,040.00	Professional		$4,200.00	$4,200.00	$5,040.00
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $2,968.00 / $2,968.00 / $2,968.00	Professional		$2,968.00	$2,968.00	$2,968.00