Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $3,128.00 / $3,128.00 / $3,128.00	Facility		$3,128.00	$3,128.00	$3,128.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $2,944.00 / $3,128.00 / $3,128.00	Professional		$2,944.00	$3,128.00	$3,128.00
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $1,183.58 / $1,354.70 / $5,347.50	Facility		$1,183.58	$1,354.70	$5,347.50
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $1,212.09 / $4,991.00 / $6,417.00	Professional		$1,212.09	$4,991.00	$6,417.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,424.19 / $3,128.00 / $3,128.00	Facility		$2,424.19	$3,128.00	$3,128.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $3,128.00 / $3,128.00 / $3,128.00	Professional		$3,128.00	$3,128.00	$3,128.00
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,330.30 / $1,330.30 / $1,330.30	Professional		$1,330.30	$1,330.30	$1,330.30
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 $530.00 / $530.00 / $79,999.20	Facility		$530.00	$530.00	$79,999.20
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,183.58 / $1,183.58 / $1,212.09	Facility		$1,183.58	$1,183.58	$1,212.09
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,098.02 / $1,212.09 / $1,283.40	Professional		$1,098.02	$1,212.09	$1,283.40
United Facility/Professional Professional Modifier Low / Median / High Price $3,200.00 / $3,200.00 / $3,840.00	Professional		$3,200.00	$3,200.00	$3,840.00
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $530.00 / $530.00 / $530.00	Professional		$530.00	$530.00	$530.00