Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $152.44 / $699.00 / $13,809.00	Facility		$152.44	$699.00	$13,809.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $75.50 / $129.62 / $287.27	Professional		$75.50	$129.62	$287.27
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $389.32 / $5,053.26 / $9,885.68	Facility		$389.32	$5,053.26	$9,885.68
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $117.60 / $238.00 / $2,873.06	Professional		$117.60	$238.00	$2,873.06
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 $107.37 / $192.98 / $409.52	Professional		$107.37	$192.98	$409.52
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $123.75 / $213.09 / $1,469.09	Facility		$123.75	$213.09	$1,469.09
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $123.75 / $214.71 / $1,192.95	Professional		$123.75	$214.71	$1,192.95
Molina Facility/Professional Professional Modifier Low / Median / High Price $45.17 / $251.08 / $441.36	Professional		$45.17	$251.08	$441.36
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $163.47 / $266.66 / $310.20	Facility		$163.47	$266.66	$310.20
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $209.29 / $211.59 / $1,040.51	Facility		$209.29	$211.59	$1,040.51
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $118.08 / $213.69 / $383.41	Professional		$118.08	$213.69	$383.41
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 $113.65 / $210.95 / $358.36	Professional		$113.65	$210.95	$358.36
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 $184.46 / $229.55 / $437.00	Professional		$184.46	$229.55	$437.00
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $88.37 / $88.37 / $170.05	Professional		$88.37	$88.37	$170.05