Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,278.80 / $5,132.00 / $22,024.00	Facility		$1,278.80	$5,132.00	$22,024.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $668.73 / $876.90 / $2,113.36	Professional		$668.73	$876.90	$2,113.36
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $974.32 / $18,220.34 / $35,644.43	Facility		$974.32	$18,220.34	$35,644.43
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $1,002.89 / $1,561.69 / $7,925.30	Professional		$1,002.89	$1,561.69	$7,925.30
Cigna Facility/Professional Facility Modifier Low / Median / High Price $714.97 / $765.00 / $870.49	Facility		$714.97	$765.00	$870.49
Cigna Facility/Professional Professional Modifier Low / Median / High Price $765.78 / $1,267.63 / $2,113.69	Professional		$765.78	$1,267.63	$2,113.69
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $801.05 / $1,436.22 / $2,078.42	Facility		$801.05	$1,436.22	$2,078.42
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $766.01 / $1,373.91 / $1,976.05	Professional		$766.01	$1,373.91	$1,976.05
Molina Facility/Professional Professional Modifier Low / Median / High Price $78.54 / $423.69 / $1,347.00	Professional		$78.54	$423.69	$1,347.00
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,068.77 / $1,354.59 / $1,466.27	Facility		$1,068.77	$1,354.59	$1,466.27
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $957.19 / $957.19 / $974.32	Facility		$957.19	$957.19	$974.32
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,086.17 / $1,563.62 / $1,933.94	Professional		$1,086.17	$1,563.62	$1,933.94
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $14,233.34 / $18,633.84 / $35,644.43	Facility		$14,233.34	$18,633.84	$35,644.43
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $976.21 / $1,386.82 / $1,846.31	Professional		$976.21	$1,386.82	$1,846.31
United Facility/Professional Facility Modifier Low / Median / High Price $3,028.00 / $5,547.00 / $19,271.00	Facility		$3,028.00	$5,547.00	$19,271.00
United Facility/Professional Professional Modifier Low / Median / High Price $890.54 / $1,180.48 / $2,046.68	Professional		$890.54	$1,180.48	$2,046.68
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $591.05 / $591.05 / $735.20	Professional		$591.05	$591.05	$735.20