Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $458.04 / $10,122.46 / $27,982.24	Facility		$458.04	$10,122.46	$27,982.24
Aetna Facility/Professional Professional Modifier Low / Median / High Price $339.27 / $458.04 / $553.75	Professional		$339.27	$458.04	$553.75
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $597.29 / $4,047.84 / $4,047.84	Facility		$597.29	$4,047.84	$4,047.84
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $603.37 / $1,034.61 / $3,814.58	Professional		$603.37	$1,034.61	$3,814.58
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,337.11 / $1,337.11 / $1,337.11	Professional		$1,337.11	$1,337.11	$1,337.11
Molina Facility/Professional Professional Modifier Low / Median / High Price $45.00 / $50.00 / $60.00	Professional		$45.00	$50.00	$60.00
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $575.08 / $839.16 / $875.69	Facility		$575.08	$839.16	$875.69
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $591.62 / $591.62 / $597.29	Facility		$591.62	$591.62	$597.29
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $626.88 / $994.50 / $1,200.34	Professional		$626.88	$994.50	$1,200.34
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $603.37 / $856.74 / $1,122.71	Professional		$603.37	$856.74	$1,122.71
United Facility/Professional Facility Modifier Low / Median / High Price $650.00 / $1,120.00 / $5,793.00	Facility		$650.00	$1,120.00	$5,793.00
United Facility/Professional Professional Modifier Low / Median / High Price $496.66 / $784.20 / $1,274.32	Professional		$496.66	$784.20	$1,274.32
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $172.08 / $172.08 / $172.08	Professional		$172.08	$172.08	$172.08