Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $387.23 / $7,190.56 / $20,680.40	Facility		$387.23	$7,190.56	$20,680.40
Aetna Facility/Professional Professional Modifier Low / Median / High Price $289.66 / $387.23 / $469.25	Professional		$289.66	$387.23	$469.25
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 $515.13 / $882.63 / $3,435.38	Professional		$515.13	$882.63	$3,435.38
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 $618.87 / $618.87 / $618.87	Professional		$618.87	$618.87	$618.87
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 $1,204.10 / $1,204.10 / $1,204.10	Professional		$1,204.10	$1,204.10	$1,204.10
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $50.00 / $65.00	Professional		$50.00	$50.00	$65.00
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $599.29 / $952.92 / $1,776.16	Facility		$599.29	$952.92	$1,776.16
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $505.10 / $537.89 / $856.87	Facility		$505.10	$537.89	$856.87
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $544.12 / $848.40 / $1,067.66	Professional		$544.12	$848.40	$1,067.66
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 $515.13 / $742.92 / $1,011.04	Professional		$515.13	$742.92	$1,011.04
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 $446.00 / $669.00 / $1,087.13	Professional		$446.00	$669.00	$1,087.13
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $141.16 / $258.05 / $385.66	Professional		$141.16	$258.05	$385.66