Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $230.66 / $5,128.00 / $22,024.00	Facility		$230.66	$5,128.00	$22,024.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $202.40 / $230.66 / $292.45	Professional		$202.40	$230.66	$292.45
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $1,081.48 / $9,636.87 / $18,444.79	Facility		$1,081.48	$9,636.87	$18,444.79
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $296.61 / $532.00 / $2,237.92	Professional		$296.61	$532.00	$2,237.92
Cigna Facility/Professional Facility Modifier Low / Median / High Price $4,605.38 / $4,605.38 / $4,605.38	Facility		$4,605.38	$4,605.38	$4,605.38
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,319.06 / $3,345.73 / $4,806.25	Facility		$1,319.06	$3,345.73	$4,806.25
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,998.04 / $3,456.07 / $4,806.25	Professional		$1,998.04	$3,456.07	$4,806.25
Molina Facility/Professional Professional Modifier Low / Median / High Price $45.00 / $50.00 / $75.00	Professional		$45.00	$50.00	$75.00
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $309.05 / $2,676.10 / $3,856.64	Facility		$309.05	$2,676.10	$3,856.64
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $298.07 / $316.24 / $4,081.09	Facility		$298.07	$316.24	$4,081.09
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $321.63 / $474.02 / $627.71	Professional		$321.63	$474.02	$627.71
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $6,160.20 / $9,428.42 / $18,444.79	Facility		$6,160.20	$9,428.42	$18,444.79
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $282.74 / $459.58 / $804.09	Professional		$282.74	$459.58	$804.09
United Facility/Professional Facility Modifier Low / Median / High Price $2,155.00 / $3,129.00 / $11,941.00	Facility		$2,155.00	$3,129.00	$11,941.00
United Facility/Professional Professional Modifier Low / Median / High Price $282.94 / $381.64 / $656.45	Professional		$282.94	$381.64	$656.45
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $327.02 / $327.02 / $327.02	Professional		$327.02	$327.02	$327.02