Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,137.46 / $2,476.21 / $17,930.00	Facility		$1,137.46	$2,476.21	$17,930.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $631.54 / $907.90 / $2,067.17	Professional		$631.54	$907.90	$2,067.17
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $1,195.06 / $5,167.93 / $11,429.12	Facility		$1,195.06	$5,167.93	$11,429.12
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $994.08 / $1,841.98 / $6,464.24	Professional		$994.08	$1,841.98	$6,464.24
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 $864.46 / $1,338.17 / $2,400.48	Professional		$864.46	$1,338.17	$2,400.48
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $951.98 / $1,461.04 / $2,184.52	Facility		$951.98	$1,461.04	$2,184.52
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $999.50 / $1,494.22 / $2,233.78	Professional		$999.50	$1,494.22	$2,233.78
Molina Facility/Professional Professional Modifier Low / Median / High Price $108.23 / $469.33 / $1,736.19	Professional		$108.23	$469.33	$1,736.19
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,134.65 / $1,619.48 / $1,752.05	Facility		$1,134.65	$1,619.48	$1,752.05
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $759.83 / $1,156.06 / $1,195.06	Facility		$759.83	$1,156.06	$1,195.06
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $999.69 / $1,659.68 / $2,190.59	Professional		$999.69	$1,659.68	$2,190.59
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 $956.80 / $1,383.57 / $2,088.50	Professional		$956.80	$1,383.57	$2,088.50
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 $1,063.28 / $1,418.12 / $2,629.60	Professional		$1,063.28	$1,418.12	$2,629.60
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $775.75 / $775.75 / $966.35	Professional		$775.75	$775.75	$966.35