Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $244.82 / $1,820.44 / $12,214.00	Facility		$244.82	$1,820.44	$12,214.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $137.62 / $435.56 / $1,117.24	Professional		$137.62	$435.56	$1,117.24
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $391.27 / $1,949.61 / $3,814.01	Facility		$391.27	$1,949.61	$3,814.01
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $190.64 / $1,116.29 / $4,683.60	Professional		$190.64	$1,116.29	$4,683.60
Cigna Facility/Professional Facility Modifier Low / Median / High Price $588.26 / $894.39 / $1,110.00	Facility		$588.26	$894.39	$1,110.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $174.20 / $442.24 / $1,704.13	Professional		$174.20	$442.24	$1,704.13
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $210.24 / $602.60 / $1,710.25	Facility		$210.24	$602.60	$1,710.25
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $210.24 / $602.60 / $1,706.15	Professional		$210.24	$602.60	$1,706.15
Molina Facility/Professional Professional Modifier Low / Median / High Price $168.28 / $953.94 / $1,706.33	Professional		$168.28	$953.94	$1,706.33
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $370.12 / $656.57 / $1,272.33	Facility		$370.12	$656.57	$1,272.33
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $277.52 / $867.84 / $901.92	Facility		$277.52	$867.84	$901.92
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $190.32 / $441.42 / $1,625.33	Professional		$190.32	$441.42	$1,625.33
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $1,292.92 / $1,992.71 / $3,814.01	Facility		$1,292.92	$1,992.71	$3,814.01
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $182.03 / $432.93 / $1,489.73	Professional		$182.03	$432.93	$1,489.73
United Facility/Professional Facility Modifier Low / Median / High Price $350.00 / $887.00 / $4,611.00	Facility		$350.00	$887.00	$4,611.00
United Facility/Professional Professional Modifier Low / Median / High Price $756.77 / $1,072.50 / $1,852.50	Professional		$756.77	$1,072.50	$1,852.50
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $138.27 / $138.27 / $713.24	Professional		$138.27	$138.27	$713.24