Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,294.80 / $5,132.00 / $22,024.00	Facility		$1,294.80	$5,132.00	$22,024.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $649.19 / $895.85 / $1,941.59	Professional		$649.19	$895.85	$1,941.59
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 $997.25 / $1,599.41 / $6,170.40	Professional		$997.25	$1,599.41	$6,170.40
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,005.16 / $1,223.70 / $3,740.43	Facility		$1,005.16	$1,223.70	$3,740.43
Cigna Facility/Professional Professional Modifier Low / Median / High Price $726.05 / $1,262.47 / $2,141.41	Professional		$726.05	$1,262.47	$2,141.41
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $737.75 / $1,496.07 / $3,280.24	Facility		$737.75	$1,496.07	$3,280.24
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $669.60 / $1,444.20 / $2,824.57	Professional		$669.60	$1,444.20	$2,824.57
Molina Facility/Professional Professional Modifier Low / Median / High Price $78.68 / $384.31 / $1,365.59	Professional		$78.68	$384.31	$1,365.59
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $978.53 / $1,321.61 / $1,420.40	Facility		$978.53	$1,321.61	$1,420.40
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $940.43 / $968.84 / $2,961.46	Facility		$940.43	$968.84	$2,961.46
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,080.01 / $1,541.24 / $1,923.05	Professional		$1,080.01	$1,541.24	$1,923.05
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $6,693.27 / $9,167.59 / $17,546.59	Facility		$6,693.27	$9,167.59	$17,546.59
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $959.11 / $1,379.02 / $1,835.92	Professional		$959.11	$1,379.02	$1,835.92
United Facility/Professional Facility Modifier Low / Median / High Price $2,155.00 / $3,129.00 / $11,941.00	Facility		$2,155.00	$3,129.00	$11,941.00
United Facility/Professional Professional Modifier Low / Median / High Price $846.84 / $1,143.99 / $1,996.90	Professional		$846.84	$1,143.99	$1,996.90
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $590.23 / $590.23 / $767.22	Professional		$590.23	$590.23	$767.22