Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $906.05 / $5,128.00 / $18,800.00	Facility		$906.05	$5,128.00	$18,800.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $186.41 / $709.10 / $1,541.04	Professional		$186.41	$709.10	$1,541.04
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $1,961.22 / $10,166.93 / $19,848.13	Facility		$1,961.22	$10,166.93	$19,848.13
Asuris Northwest Health Facility/Professional Facility Modifier AS Low / Median / High Price $632.66 / $1,052.31 / $1,052.31	Facility	AS	$632.66	$1,052.31	$1,052.31
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $914.30 / $1,594.53 / $5,863.65	Professional		$914.30	$1,594.53	$5,863.65
Cigna Facility/Professional Facility Modifier Low / Median / High Price $644.92 / $1,110.00 / $4,636.17	Facility		$644.92	$1,110.00	$4,636.17
Cigna Facility/Professional Professional Modifier Low / Median / High Price $751.49 / $1,140.51 / $2,061.17	Professional		$751.49	$1,140.51	$2,061.17
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $847.44 / $1,415.44 / $4,240.71	Facility		$847.44	$1,415.44	$4,240.71
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $847.44 / $1,415.44 / $4,065.76	Professional		$847.44	$1,415.44	$4,065.76
Molina Facility/Professional Professional Modifier Low / Median / High Price $73.07 / $373.32 / $1,290.95	Professional		$73.07	$373.32	$1,290.95
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $944.72 / $1,285.73 / $1,360.77	Facility		$944.72	$1,285.73	$1,360.77
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $896.49 / $928.17 / $1,961.22	Facility		$896.49	$928.17	$1,961.22
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $928.17 / $1,529.41 / $1,842.32	Professional		$928.17	$1,529.41	$1,842.32
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $6,832.97 / $10,161.12 / $19,448.18	Facility		$6,832.97	$10,161.12	$19,448.18
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $903.61 / $1,248.05 / $1,718.64	Professional		$903.61	$1,248.05	$1,718.64
United Facility/Professional Facility Modifier Low / Median / High Price $1,403.00 / $2,428.00 / $11,941.00	Facility		$1,403.00	$2,428.00	$11,941.00
United Facility/Professional Professional Modifier Low / Median / High Price $800.10 / $999.44 / $1,940.65	Professional		$800.10	$999.44	$1,940.65
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $738.66 / $738.66 / $738.66	Professional		$738.66	$738.66	$738.66