Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $891.18 / $2,166.23 / $12,214.00	Facility		$891.18	$2,166.23	$12,214.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $520.40 / $769.05 / $1,731.87	Professional		$520.40	$769.05	$1,731.87
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $1,047.44 / $5,167.93 / $11,429.12	Facility		$1,047.44	$5,167.93	$11,429.12
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $867.03 / $1,598.51 / $5,675.84	Professional		$867.03	$1,598.51	$5,675.84
Cigna Facility/Professional Facility Modifier Low / Median / High Price $564.00 / $906.00 / $2,323.83	Facility		$564.00	$906.00	$2,323.83
Cigna Facility/Professional Professional Modifier Low / Median / High Price $756.20 / $1,170.58 / $2,113.91	Professional		$756.20	$1,170.58	$2,113.91
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $837.40 / $1,280.16 / $1,959.38	Facility		$837.40	$1,280.16	$1,959.38
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $881.00 / $1,369.65 / $2,113.52	Professional		$881.00	$1,369.65	$2,113.52
Molina Facility/Professional Professional Modifier Low / Median / High Price $75.04 / $440.77 / $1,519.93	Professional		$75.04	$440.77	$1,519.93
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,036.26 / $1,435.73 / $1,572.27	Facility		$1,036.26	$1,435.73	$1,572.27
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $759.83 / $1,040.51 / $1,047.44	Facility		$759.83	$1,040.51	$1,047.44
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $880.31 / $1,460.40 / $1,920.01	Professional		$880.31	$1,460.40	$1,920.01
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 $840.38 / $1,218.34 / $1,830.54	Professional		$840.38	$1,218.34	$1,830.54
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 $912.60 / $1,153.67 / $2,165.69	Professional		$912.60	$1,153.67	$2,165.69
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $683.43 / $683.43 / $846.02	Professional		$683.43	$683.43	$846.02