Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $988.00 / $5,128.00 / $21,917.86	Facility		$988.00	$5,128.00	$21,917.86
Aetna Facility/Professional Professional Modifier Low / Median / High Price $521.08 / $785.61 / $1,750.32	Professional		$521.08	$785.61	$1,750.32
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $2,961.46 / $9,172.83 / $20,286.13	Facility		$2,961.46	$9,172.83	$20,286.13
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $792.30 / $1,302.55 / $9,877.00	Professional		$792.30	$1,302.55	$9,877.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $883.20 / $1,075.31 / $3,740.43	Facility		$883.20	$1,075.31	$3,740.43
Cigna Facility/Professional Professional Modifier Low / Median / High Price $552.95 / $1,012.03 / $1,720.17	Professional		$552.95	$1,012.03	$1,720.17
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $548.97 / $1,120.56 / $3,280.24	Facility		$548.97	$1,120.56	$3,280.24
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $514.72 / $1,108.08 / $2,824.57	Professional		$514.72	$1,108.08	$2,824.57
Molina Facility/Professional Professional Modifier Low / Median / High Price $77.42 / $317.80 / $1,132.97	Professional		$77.42	$317.80	$1,132.97
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $749.52 / $1,036.49 / $1,139.00	Facility		$749.52	$1,036.49	$1,139.00
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $751.07 / $776.90 / $2,961.46	Facility		$751.07	$776.90	$2,961.46
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $864.04 / $1,235.90 / $1,542.07	Professional		$864.04	$1,235.90	$1,542.07
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $5,948.17 / $9,167.59 / $17,546.59	Facility		$5,948.17	$9,167.59	$17,546.59
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $766.00 / $1,105.82 / $1,480.16	Professional		$766.00	$1,105.82	$1,480.16
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 $654.36 / $925.09 / $1,623.96	Professional		$654.36	$925.09	$1,623.96
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $473.45 / $473.45 / $618.57	Professional		$473.45	$473.45	$618.57