Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $876.18 / $2,070.30 / $14,960.00	Facility		$876.18	$2,070.30	$14,960.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $568.95 / $834.46 / $1,702.68	Professional		$568.95	$834.46	$1,702.68
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $1,118.74 / $5,167.93 / $11,429.12	Facility		$1,118.74	$5,167.93	$11,429.12
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $920.64 / $1,710.62 / $6,000.88	Professional		$920.64	$1,710.62	$6,000.88
Cigna Facility/Professional Facility Modifier Low / Median / High Price $644.92 / $1,110.00 / $2,323.83	Facility		$644.92	$1,110.00	$2,323.83
Cigna Facility/Professional Professional Modifier Low / Median / High Price $797.44 / $1,233.78 / $2,206.32	Professional		$797.44	$1,233.78	$2,206.32
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $854.30 / $1,341.76 / $2,086.29	Facility		$854.30	$1,341.76	$2,086.29
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $905.00 / $1,410.61 / $2,125.62	Professional		$905.00	$1,410.61	$2,125.62
Molina Facility/Professional Professional Modifier Low / Median / High Price $75.04 / $453.68 / $1,591.27	Professional		$75.04	$453.68	$1,591.27
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,071.59 / $1,499.44 / $1,640.16	Facility		$1,071.59	$1,499.44	$1,640.16
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $759.83 / $1,085.83 / $1,118.74	Facility		$759.83	$1,085.83	$1,118.74
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $924.02 / $1,533.65 / $2,050.69	Professional		$924.02	$1,533.65	$2,050.69
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $3,351.17 / $5,167.93 / $9,885.68	Facility		$3,351.17	$5,167.93	$9,885.68
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $886.12 / $1,278.83 / $1,956.21	Professional		$886.12	$1,278.83	$1,956.21
United Facility/Professional Facility Modifier Low / Median / High Price $629.00 / $1,120.00 / $6,857.00	Facility		$629.00	$1,120.00	$6,857.00
United Facility/Professional Professional Modifier Low / Median / High Price $980.19 / $1,178.83 / $2,345.19	Professional		$980.19	$1,178.83	$2,345.19
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $712.30 / $712.30 / $899.74	Professional		$712.30	$712.30	$899.74