Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,264.33 / $6,470.00 / $22,024.00	Facility		$1,264.33	$6,470.00	$22,024.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $633.77 / $874.74 / $1,838.38	Professional		$633.77	$874.74	$1,838.38
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $6,713.85 / $20,273.81 / $38,781.51	Facility		$6,713.85	$20,273.81	$38,781.51
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $973.73 / $1,579.83 / $6,024.83	Professional		$973.73	$1,579.83	$6,024.83
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,005.16 / $1,223.70 / $8,315.84	Facility		$1,005.16	$1,223.70	$8,315.84
Cigna Facility/Professional Professional Modifier Low / Median / High Price $708.17 / $1,232.76 / $2,091.46	Professional		$708.17	$1,232.76	$2,091.46
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $720.62 / $1,457.69 / $7,292.72	Facility		$720.62	$1,457.69	$7,292.72
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $653.33 / $1,407.95 / $6,279.70	Professional		$653.33	$1,407.95	$6,279.70
Molina Facility/Professional Professional Modifier Low / Median / High Price $78.68 / $384.31 / $1,333.92	Professional		$78.68	$384.31	$1,333.92
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $931.21 / $1,287.74 / $1,386.90	Facility		$931.21	$1,287.74	$1,386.90
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $916.87 / $945.99 / $8,497.21	Facility		$916.87	$945.99	$8,497.21
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,054.32 / $1,504.89 / $1,877.70	Professional		$1,054.32	$1,504.89	$1,877.70
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $13,146.66 / $20,262.22 / $38,781.51	Facility		$13,146.66	$20,262.22	$38,781.51
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $935.09 / $1,346.49 / $1,805.76	Professional		$935.09	$1,346.49	$1,805.76
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 $821.94 / $1,076.33 / $1,949.41	Professional		$821.94	$1,076.33	$1,949.41
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $577.53 / $577.53 / $751.08	Professional		$577.53	$577.53	$751.08