Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,264.18 / $5,128.00 / $21,917.86	Facility		$1,264.18	$5,128.00	$21,917.86
Aetna Facility/Professional Professional Modifier Low / Median / High Price $692.21 / $888.68 / $2,163.83	Professional		$692.21	$888.68	$2,163.83
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $7,750.73 / $16,547.20 / $31,745.76	Facility		$7,750.73	$16,547.20	$31,745.76
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $952.09 / $1,583.60 / $5,843.40	Professional		$952.09	$1,583.60	$5,843.40
Cigna Facility/Professional Facility Modifier Low / Median / High Price $883.20 / $1,075.31 / $6,910.09	Facility		$883.20	$1,075.31	$6,910.09
Cigna Facility/Professional Professional Modifier Low / Median / High Price $720.12 / $1,284.69 / $2,077.46	Professional		$720.12	$1,284.69	$2,077.46
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $777.78 / $1,554.87 / $6,059.92	Facility		$777.78	$1,554.87	$6,059.92
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $719.63 / $1,464.00 / $5,218.14	Professional		$719.63	$1,464.00	$5,218.14
Molina Facility/Professional Professional Modifier Low / Median / High Price $78.68 / $398.78 / $1,346.45	Professional		$78.68	$398.78	$1,346.45
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,046.04 / $1,324.52 / $1,446.53	Facility		$1,046.04	$1,324.52	$1,446.53
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $910.08 / $924.97 / $7,750.73	Facility		$910.08	$924.97	$7,750.73
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,040.45 / $1,486.66 / $1,835.97	Professional		$1,040.45	$1,486.66	$1,835.97
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $10,761.59 / $16,586.25 / $31,745.76	Facility		$10,761.59	$16,586.25	$31,745.76
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $928.16 / $1,316.57 / $1,782.00	Professional		$928.16	$1,316.57	$1,782.00
United Facility/Professional Facility Modifier Low / Median / High Price $1,547.00 / $2,408.00 / $10,522.00	Facility		$1,547.00	$2,408.00	$10,522.00
United Facility/Professional Professional Modifier Low / Median / High Price $788.28 / $1,086.19 / $1,882.44	Professional		$788.28	$1,086.19	$1,882.44
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $560.41 / $560.41 / $749.89	Professional		$560.41	$560.41	$749.89