Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $3,514.45 / $6,988.10 / $22,024.00	Facility		$3,514.45	$6,988.10	$22,024.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $2,475.39 / $3,514.45 / $7,701.08	Professional		$2,475.39	$3,514.45	$7,701.08
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $3,812.29 / $46,149.28 / $90,281.73	Facility		$3,812.29	$46,149.28	$90,281.73
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $3,924.08 / $6,313.95 / $24,287.33	Professional		$3,924.08	$6,313.95	$24,287.33
Cigna Facility/Professional Facility Modifier Low / Median / High Price $765.00 / $870.49 / $870.49	Facility		$765.00	$870.49	$870.49
Cigna Facility/Professional Professional Modifier Low / Median / High Price $2,728.63 / $4,958.24 / $8,376.24	Professional		$2,728.63	$4,958.24	$8,376.24
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $2,383.59 / $5,056.17 / $7,031.50	Facility		$2,383.59	$5,056.17	$7,031.50
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $2,383.59 / $4,874.95 / $6,619.04	Professional		$2,383.59	$4,874.95	$6,619.04
Molina Facility/Professional Professional Modifier Low / Median / High Price $294.66 / $1,592.15 / $5,400.76	Professional		$294.66	$1,592.15	$5,400.76
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $3,764.57 / $5,120.39 / $5,589.14	Facility		$3,764.57	$5,120.39	$5,589.14
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $3,731.81 / $3,731.81 / $3,812.29	Facility		$3,731.81	$3,731.81	$3,812.29
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $4,263.51 / $6,096.12 / $7,567.03	Professional		$4,263.51	$6,096.12	$7,567.03
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $36,050.80 / $47,196.58 / $90,281.73	Facility		$36,050.80	$47,196.58	$90,281.73
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $3,805.96 / $5,426.30 / $7,225.14	Professional		$3,805.96	$5,426.30	$7,225.14
United Facility/Professional Facility Modifier Low / Median / High Price $3,700.00 / $7,614.00 / $24,236.00	Facility		$3,700.00	$7,614.00	$24,236.00
United Facility/Professional Professional Modifier Low / Median / High Price $3,149.09 / $4,515.84 / $7,983.37	Professional		$3,149.09	$4,515.84	$7,983.37
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $2,318.69 / $2,318.69 / $2,964.86	Professional		$2,318.69	$2,318.69	$2,964.86