Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,292.59 / $5,128.00 / $20,680.40	Facility		$1,292.59	$5,128.00	$20,680.40
Aetna Facility/Professional Professional Modifier Low / Median / High Price $627.92 / $895.96 / $2,011.68	Professional		$627.92	$895.96	$2,011.68
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $2,318.75 / $8,052.47 / $17,808.41	Facility		$2,318.75	$8,052.47	$17,808.41
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $989.72 / $1,612.00 / $6,077.18	Professional		$989.72	$1,612.00	$6,077.18
Cigna Facility/Professional Facility Modifier Low / Median / High Price $714.97 / $870.49 / $2,846.84	Facility		$714.97	$870.49	$2,846.84
Cigna Facility/Professional Professional Modifier Low / Median / High Price $706.21 / $1,254.66 / $2,131.87	Professional		$706.21	$1,254.66	$2,131.87
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $651.00 / $1,455.93 / $2,496.58	Facility		$651.00	$1,455.93	$2,496.58
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $651.00 / $1,409.94 / $2,192.16	Professional		$651.00	$1,409.94	$2,192.16
Molina Facility/Professional Professional Modifier Low / Median / High Price $78.68 / $397.59 / $1,415.65	Professional		$78.68	$397.59	$1,415.65
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $815.26 / $1,358.76 / $1,409.68	Facility		$815.26	$1,358.76	$1,409.68
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $738.78 / $937.71 / $2,218.36	Facility		$738.78	$937.71	$2,218.36
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,075.90 / $1,531.80 / $1,908.54	Professional		$1,075.90	$1,531.80	$1,908.54
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 $956.34 / $1,368.61 / $1,822.06	Professional		$956.34	$1,368.61	$1,822.06
United Facility/Professional Facility Modifier Low / Median / High Price $1,436.00 / $9,921.79 / $16,373.27	Facility		$1,436.00	$9,921.79	$16,373.27
United Facility/Professional Professional Modifier Low / Median / High Price $709.94 / $1,176.24 / $2,021.76	Professional		$709.94	$1,176.24	$2,021.76
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $587.20 / $587.20 / $762.45	Professional		$587.20	$587.20	$762.45