Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $801.00 / $10,700.00 / $22,024.00	Facility		$801.00	$10,700.00	$22,024.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $323.74 / $533.76 / $739.32	Professional		$323.74	$533.76	$739.32
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $6,674.32 / $11,082.10 / $21,287.95	Facility		$6,674.32	$11,082.10	$21,287.95
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $703.63 / $1,204.82 / $4,447.95	Professional		$703.63	$1,204.82	$4,447.95
Cigna Facility/Professional Facility Modifier Low / Median / High Price $4,627.88 / $4,627.88 / $4,627.88	Facility		$4,627.88	$4,627.88	$4,627.88
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $2,925.68 / $4,058.50 / $15,792.93	Facility		$2,925.68	$4,058.50	$15,792.93
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,559.02 / $2,925.68 / $5,567.86	Professional		$1,559.02	$2,925.68	$5,567.86
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $50.00 / $50.00	Professional		$50.00	$50.00	$50.00
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $765.04 / $2,871.94 / $3,705.41	Facility		$765.04	$2,871.94	$3,705.41
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $689.92 / $689.92 / $696.47	Facility		$689.92	$689.92	$696.47
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $716.89 / $1,158.08 / $1,386.09	Professional		$716.89	$1,158.08	$1,386.09
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $7,246.24 / $10,881.75 / $21,287.95	Facility		$7,246.24	$10,881.75	$21,287.95
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $703.63 / $946.00 / $1,274.23	Professional		$703.63	$946.00	$1,274.23
United Facility/Professional Facility Modifier Low / Median / High Price $2,155.00 / $6,594.00 / $12,835.00	Facility		$2,155.00	$6,594.00	$12,835.00
United Facility/Professional Professional Modifier Low / Median / High Price $670.12 / $944.25 / $1,507.76	Professional		$670.12	$944.25	$1,507.76