Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $301.77 / $5,128.00 / $22,024.00	Facility		$301.77	$5,128.00	$22,024.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $225.74 / $301.77 / $365.82	Professional		$225.74	$301.77	$365.82
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $830.70 / $4,901.45 / $7,286.95	Facility		$830.70	$4,901.45	$7,286.95
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $400.75 / $684.51 / $2,672.63	Professional		$400.75	$684.51	$2,672.63
Cigna Facility/Professional Facility Modifier Low / Median / High Price $500.00 / $870.49 / $2,046.84	Facility		$500.00	$870.49	$2,046.84
Cigna Facility/Professional Professional Modifier Low / Median / High Price $481.63 / $481.63 / $481.63	Professional		$481.63	$481.63	$481.63
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $826.39 / $2,445.16 / $7,407.84	Facility		$826.39	$2,445.16	$7,407.84
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $937.13 / $937.13 / $937.13	Professional		$937.13	$937.13	$937.13
Molina Facility/Professional Professional Modifier Low / Median / High Price $30.00 / $30.00 / $60.00	Professional		$30.00	$30.00	$60.00
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $280.79 / $927.86 / $1,770.14	Facility		$280.79	$927.86	$1,770.14
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $393.66 / $533.26 / $856.87	Facility		$393.66	$533.26	$856.87
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $424.07 / $661.22 / $830.90	Professional		$424.07	$661.22	$830.90
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $3,303.45 / $5,389.29 / $10,315.01	Facility		$3,303.45	$5,389.29	$10,315.01
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $401.48 / $595.27 / $786.84	Professional		$401.48	$595.27	$786.84
United Facility/Professional Facility Modifier Low / Median / High Price $650.00 / $1,120.00 / $6,857.00	Facility		$650.00	$1,120.00	$6,857.00
United Facility/Professional Professional Modifier Low / Median / High Price $344.98 / $521.40 / $872.91	Professional		$344.98	$521.40	$872.91
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $133.29 / $233.86 / $360.55	Professional		$133.29	$233.86	$360.55