Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,108.99 / $2,145.33 / $18,711.00	Facility		$1,108.99	$2,145.33	$18,711.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $586.00 / $862.52 / $1,915.70	Professional		$586.00	$862.52	$1,915.70
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $1,157.11 / $5,167.93 / $11,429.12	Facility		$1,157.11	$5,167.93	$11,429.12
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $949.44 / $1,753.65 / $6,214.80	Professional		$949.44	$1,753.65	$6,214.80
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 $826.77 / $1,277.83 / $2,270.44	Professional		$826.77	$1,277.83	$2,270.44
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $868.05 / $1,392.72 / $2,125.62	Facility		$868.05	$1,392.72	$2,125.62
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $929.50 / $1,419.16 / $2,158.32	Professional		$929.50	$1,419.16	$2,158.32
Molina Facility/Professional Professional Modifier Low / Median / High Price $75.04 / $453.68 / $1,647.85	Professional		$75.04	$453.68	$1,647.85
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,072.80 / $1,524.25 / $1,696.44	Facility		$1,072.80	$1,524.25	$1,696.44
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $759.83 / $1,126.60 / $1,157.11	Facility		$759.83	$1,126.60	$1,157.11
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $951.75 / $1,578.55 / $2,121.06	Professional		$951.75	$1,578.55	$2,121.06
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 $913.84 / $1,317.22 / $2,041.37	Professional		$913.84	$1,317.22	$2,041.37
United Facility/Professional Facility Modifier Low / Median / High Price $1,232.00 / $1,981.00 / $10,522.00	Facility		$1,232.00	$1,981.00	$10,522.00
United Facility/Professional Professional Modifier Low / Median / High Price $996.50 / $1,190.51 / $2,386.41	Professional		$996.50	$1,190.51	$2,386.41
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $733.11 / $733.11 / $928.45	Professional		$733.11	$733.11	$928.45