Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,253.44 / $5,128.00 / $21,917.86	Facility		$1,253.44	$5,128.00	$21,917.86
Aetna Facility/Professional Professional Modifier Low / Median / High Price $610.34 / $867.44 / $1,864.91	Professional		$610.34	$867.44	$1,864.91
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $6,400.95 / $19,913.50 / $38,781.51	Facility		$6,400.95	$19,913.50	$38,781.51
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $964.79 / $1,588.40 / $5,969.85	Professional		$964.79	$1,588.40	$5,969.85
Cigna Facility/Professional Facility Modifier Low / Median / High Price $883.20 / $1,075.31 / $8,315.84	Facility		$883.20	$1,075.31	$8,315.84
Cigna Facility/Professional Professional Modifier Low / Median / High Price $691.81 / $1,222.14 / $2,075.63	Professional		$691.81	$1,222.14	$2,075.63
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $707.53 / $1,433.49 / $7,292.72	Facility		$707.53	$1,433.49	$7,292.72
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $634.53 / $1,361.55 / $6,279.70	Professional		$634.53	$1,361.55	$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 $945.20 / $1,264.96 / $1,374.17	Facility		$945.20	$1,264.96	$1,374.17
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $907.81 / $937.31 / $6,526.97	Facility		$907.81	$937.31	$6,526.97
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,043.53 / $1,491.08 / $1,860.46	Professional		$1,043.53	$1,491.08	$1,860.46
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $12,546.63 / $20,262.22 / $38,781.51	Facility		$12,546.63	$20,262.22	$38,781.51
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $925.85 / $1,334.13 / $1,787.28	Professional		$925.85	$1,334.13	$1,787.28
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 $816.00 / $1,091.00 / $1,960.93	Professional		$816.00	$1,091.00	$1,960.93
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $571.74 / $571.74 / $746.97	Professional		$571.74	$571.74	$746.97