Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,200.50 / $5,132.00 / $22,024.00	Facility		$1,200.50	$5,132.00	$22,024.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $644.27 / $823.93 / $1,848.36	Professional		$644.27	$823.93	$1,848.36
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $1,771.02 / $15,599.20 / $31,745.76	Facility		$1,771.02	$15,599.20	$31,745.76
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $882.92 / $1,413.75 / $6,294.01	Professional		$882.92	$1,413.75	$6,294.01
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,005.16 / $1,223.70 / $6,910.09	Facility		$1,005.16	$1,223.70	$6,910.09
Cigna Facility/Professional Professional Modifier Low / Median / High Price $694.42 / $1,170.52 / $1,964.28	Professional		$694.42	$1,170.52	$1,964.28
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $683.82 / $1,390.04 / $6,059.92	Facility		$683.82	$1,390.04	$6,059.92
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $631.04 / $1,354.70 / $5,218.14	Professional		$631.04	$1,354.70	$5,218.14
Molina Facility/Professional Professional Modifier Low / Median / High Price $78.68 / $372.59 / $1,236.26	Professional		$78.68	$372.59	$1,236.26
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $934.92 / $1,244.19 / $1,294.44	Facility		$934.92	$1,244.19	$1,294.44
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $858.44 / $882.92 / $5,317.93	Facility		$858.44	$882.92	$5,317.93
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $993.69 / $1,404.56 / $1,752.52	Professional		$993.69	$1,404.56	$1,752.52
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 $875.49 / $1,256.72 / $1,701.92	Professional		$875.49	$1,256.72	$1,701.92
United Facility/Professional Facility Modifier Low / Median / High Price $2,912.00 / $4,016.00 / $16,315.00	Facility		$2,912.00	$4,016.00	$16,315.00
United Facility/Professional Professional Modifier Low / Median / High Price $776.16 / $1,050.89 / $1,837.31	Professional		$776.16	$1,050.89	$1,837.31
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $543.03 / $543.03 / $709.99	Professional		$543.03	$543.03	$709.99