Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $769.22 / $11,647.00 / $24,857.24	Facility		$769.22	$11,647.00	$24,857.24
Aetna Facility/Professional Professional Modifier Low / Median / High Price $204.54 / $769.22 / $1,357.35	Professional		$204.54	$769.22	$1,357.35
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $9,755.33 / $15,035.65 / $30,895.07	Facility		$9,755.33	$15,035.65	$30,895.07
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $1,079.78 / $1,896.16 / $7,713.75	Professional		$1,079.78	$1,896.16	$7,713.75
Cigna Facility/Professional Facility Modifier Low / Median / High Price $500.00 / $714.97 / $947.00	Facility		$500.00	$714.97	$947.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,133.27 / $1,342.15 / $1,389.69	Professional		$1,133.27	$1,342.15	$1,389.69
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $2,855.29 / $5,140.85 / $19,856.73	Facility		$2,855.29	$5,140.85	$19,856.73
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $2,703.73 / $3,482.23 / $4,894.29	Professional		$2,703.73	$3,482.23	$4,894.29
Molina Facility/Professional Professional Modifier Low / Median / High Price $60.00 / $89.34 / $893.46	Professional		$60.00	$89.34	$893.46
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $578.72 / $812.24 / $5,544.22	Facility		$578.72	$812.24	$5,544.22
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,128.88 / $1,128.88 / $1,207.84	Facility		$1,128.88	$1,128.88	$1,207.84
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,158.77 / $1,871.51 / $2,397.46	Professional		$1,158.77	$1,871.51	$2,397.46
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $10,473.20 / $16,151.01 / $30,895.07	Facility		$10,473.20	$16,151.01	$30,895.07
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $1,151.30 / $1,650.63 / $2,255.23	Professional		$1,151.30	$1,650.63	$2,255.23
United Facility/Professional Facility Modifier Low / Median / High Price $1,300.00 / $2,759.00 / $11,941.00	Facility		$1,300.00	$2,759.00	$11,941.00
United Facility/Professional Professional Modifier Low / Median / High Price $343.74 / $735.76 / $2,342.88	Professional		$343.74	$735.76	$2,342.88
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $862.39 / $869.18 / $869.18	Professional		$862.39	$869.18	$869.18