Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,155.27 / $1,733.00 / $18,711.00	Facility		$1,155.27	$1,733.00	$18,711.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $570.58 / $937.55 / $2,195.01	Professional		$570.58	$937.55	$2,195.01
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $616.09 / $7,547.82 / $15,403.47	Facility		$616.09	$7,547.82	$15,403.47
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $924.48 / $1,764.60 / $6,335.28	Professional		$924.48	$1,764.60	$6,335.28
Cigna Facility/Professional Facility Modifier Low / Median / High Price $644.92 / $1,110.00 / $1,214.36	Facility		$644.92	$1,110.00	$1,214.36
Cigna Facility/Professional Professional Modifier Low / Median / High Price $849.33 / $1,323.24 / $2,265.35	Professional		$849.33	$1,323.24	$2,265.35
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $835.82 / $1,346.51 / $2,193.48	Facility		$835.82	$1,346.51	$2,193.48
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $860.91 / $1,427.39 / $2,136.41	Professional		$860.91	$1,427.39	$2,136.41
Molina Facility/Professional Professional Modifier Low / Median / High Price $110.12 / $463.50 / $1,706.33	Professional		$110.12	$463.50	$1,706.33
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,005.48 / $1,578.52 / $1,708.50	Facility		$1,005.48	$1,578.52	$1,708.50
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $559.44 / $1,129.33 / $1,165.34	Facility		$559.44	$1,129.33	$1,165.34
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $936.71 / $1,560.24 / $2,136.14	Professional		$936.71	$1,560.24	$2,136.14
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $5,221.67 / $8,047.87 / $15,403.47	Facility		$5,221.67	$8,047.87	$15,403.47
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $889.81 / $1,304.33 / $2,090.66	Professional		$889.81	$1,304.33	$2,090.66
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 $1,029.57 / $1,254.25 / $2,457.01	Professional		$1,029.57	$1,254.25	$2,457.01
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $731.86 / $731.86 / $944.57	Professional		$731.86	$731.86	$944.57