Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $186.11 / $5,128.00 / $22,024.00	Facility		$186.11	$5,128.00	$22,024.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $163.56 / $186.11 / $204.25	Professional		$163.56	$186.11	$204.25
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $927.31 / $2,583.03 / $4,941.05	Facility		$927.31	$2,583.03	$4,941.05
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $245.78 / $402.91 / $1,660.05	Professional		$245.78	$402.91	$1,660.05
Cigna Facility/Professional Facility Modifier Low / Median / High Price $500.00 / $870.49 / $1,132.06	Facility		$500.00	$870.49	$1,132.06
Cigna Facility/Professional Professional Modifier Low / Median / High Price $224.59 / $224.59 / $269.08	Professional		$224.59	$224.59	$269.08
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $635.38 / $871.71 / $3,219.57	Facility		$635.38	$871.71	$3,219.57
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $582.22 / $849.54 / $1,181.43	Professional		$582.22	$849.54	$1,181.43
Molina Facility/Professional Professional Modifier Low / Median / High Price $60.00 / $75.00 / $173.82	Professional		$60.00	$75.00	$173.82
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $77.23 / $166.51 / $860.29	Facility		$77.23	$166.51	$860.29
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $241.00 / $260.02 / $927.31	Facility		$241.00	$260.02	$927.31
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $273.29 / $398.10 / $516.14	Professional		$273.29	$398.10	$516.14
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $1,674.98 / $2,581.55 / $4,941.05	Facility		$1,674.98	$2,581.55	$4,941.05
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $245.78 / $350.28 / $492.75	Professional		$245.78	$350.28	$492.75
United Facility/Professional Facility Modifier Low / Median / High Price $472.00 / $938.00 / $4,611.00	Facility		$472.00	$938.00	$4,611.00
United Facility/Professional Professional Modifier Low / Median / High Price $215.84 / $291.67 / $526.37	Professional		$215.84	$291.67	$526.37
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $101.67 / $185.64 / $193.35	Professional		$101.67	$185.64	$193.35