Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,074.54 / $5,128.00 / $21,917.86	Facility		$1,074.54	$5,128.00	$21,917.86
Aetna Facility/Professional Professional Modifier Low / Median / High Price $538.00 / $743.58 / $1,618.15	Professional		$538.00	$743.58	$1,618.15
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 $827.43 / $1,337.64 / $5,120.47	Professional		$827.43	$1,337.64	$5,120.47
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 $596.23 / $1,047.71 / $1,779.32	Professional		$596.23	$1,047.71	$1,779.32
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $594.64 / $1,215.23 / $3,280.24	Facility		$594.64	$1,215.23	$3,280.24
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $552.26 / $1,188.27 / $2,824.57	Professional		$552.26	$1,188.27	$2,824.57
Molina Facility/Professional Professional Modifier Low / Median / High Price $78.02 / $359.18 / $1,150.47	Professional		$78.02	$359.18	$1,150.47
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $799.19 / $1,098.80 / $1,178.53	Facility		$799.19	$1,098.80	$1,178.53
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $777.80 / $803.86 / $2,961.46	Facility		$777.80	$803.86	$2,961.46
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $895.04 / $1,278.79 / $1,595.59	Professional		$895.04	$1,278.79	$1,595.59
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 $793.25 / $1,144.20 / $1,532.96	Professional		$793.25	$1,144.20	$1,532.96
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 $694.68 / $942.78 / $1,661.44	Professional		$694.68	$942.78	$1,661.44
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $490.02 / $490.02 / $639.53	Professional		$490.02	$490.02	$639.53