Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,169.09 / $8,617.81 / $20,680.40	Facility		$1,169.09	$8,617.81	$20,680.40
Aetna Facility/Professional Professional Modifier Low / Median / High Price $624.82 / $828.83 / $1,938.02	Professional		$624.82	$828.83	$1,938.02
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $1,771.02 / $15,449.66 / $31,745.76	Facility		$1,771.02	$15,449.66	$31,745.76
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $895.26 / $1,451.26 / $5,563.75	Professional		$895.26	$1,451.26	$5,563.75
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 $691.30 / $1,181.32 / $1,919.05	Professional		$691.30	$1,181.32	$1,919.05
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $644.17 / $1,315.97 / $1,952.81	Facility		$644.17	$1,315.97	$1,952.81
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $644.17 / $1,295.90 / $1,696.72	Professional		$644.17	$1,295.90	$1,696.72
Molina Facility/Professional Professional Modifier Low / Median / High Price $78.54 / $371.01 / $1,236.62	Professional		$78.54	$371.01	$1,236.62
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $953.54 / $1,245.64 / $1,306.50	Facility		$953.54	$1,245.64	$1,306.50
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $838.96 / $856.88 / $5,317.93	Facility		$838.96	$856.88	$5,317.93
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $968.51 / $1,365.87 / $1,700.81	Professional		$968.51	$1,365.87	$1,700.81
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $12,109.64 / $16,595.73 / $31,745.76	Facility		$12,109.64	$16,595.73	$31,745.76
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $855.62 / $1,220.34 / $1,660.31	Professional		$855.62	$1,220.34	$1,660.31
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 $774.90 / $1,033.19 / $1,819.96	Professional		$774.90	$1,033.19	$1,819.96
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $529.22 / $529.22 / $691.56	Professional		$529.22	$529.22	$691.56