Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $801.00 / $5,128.00 / $18,800.00	Facility		$801.00	$5,128.00	$18,800.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $465.00 / $792.38 / $1,526.02	Professional		$465.00	$792.38	$1,526.02
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $877.90 / $4,591.92 / $10,161.06	Facility		$877.90	$4,591.92	$10,161.06
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $871.33 / $1,492.37 / $5,571.83	Professional		$871.33	$1,492.37	$5,571.83
Cigna Facility/Professional Facility Modifier Low / Median / High Price $644.92 / $1,110.00 / $1,677.65	Facility		$644.92	$1,110.00	$1,677.65
Cigna Facility/Professional Professional Modifier Low / Median / High Price $670.90 / $1,041.05 / $1,948.19	Professional		$670.90	$1,041.05	$1,948.19
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $738.19 / $1,130.32 / $1,719.31	Facility		$738.19	$1,130.32	$1,719.31
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $738.19 / $1,163.53 / $1,813.61	Professional		$738.19	$1,163.53	$1,813.61
Molina Facility/Professional Professional Modifier Low / Median / High Price $71.55 / $370.10 / $1,280.55	Professional		$71.55	$370.10	$1,280.55
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $822.68 / $1,137.66 / $1,287.07	Facility		$822.68	$1,137.66	$1,287.07
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $504.88 / $854.36 / $877.90	Facility		$504.88	$854.36	$877.90
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $877.90 / $1,430.00 / $1,742.54	Professional		$877.90	$1,430.00	$1,742.54
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $3,509.52 / $4,594.55 / $8,788.86	Facility		$3,509.52	$4,594.55	$8,788.86
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $861.15 / $1,180.45 / $1,590.02	Professional		$861.15	$1,180.45	$1,590.02
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 $718.50 / $915.72 / $1,845.06	Professional		$718.50	$915.72	$1,845.06
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $700.97 / $700.97 / $700.97	Professional		$700.97	$700.97	$700.97