Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,162.08 / $5,128.00 / $20,680.40	Facility		$1,162.08	$5,128.00	$20,680.40
Aetna Facility/Professional Professional Modifier Low / Median / High Price $582.08 / $804.71 / $1,746.71	Professional		$582.08	$804.71	$1,746.71
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $2,986.86 / $9,172.83 / $20,286.13	Facility		$2,986.86	$9,172.83	$20,286.13
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $895.64 / $1,475.57 / $5,542.80	Professional		$895.64	$1,475.57	$5,542.80
Cigna Facility/Professional Facility Modifier Low / Median / High Price $714.97 / $870.49 / $3,740.43	Facility		$714.97	$870.49	$3,740.43
Cigna Facility/Professional Professional Modifier Low / Median / High Price $647.97 / $1,133.07 / $1,925.50	Professional		$647.97	$1,133.07	$1,925.50
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $641.62 / $1,312.95 / $3,280.24	Facility		$641.62	$1,312.95	$3,280.24
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $598.89 / $1,289.77 / $2,824.57	Professional		$598.89	$1,289.77	$2,824.57
Molina Facility/Professional Professional Modifier Low / Median / High Price $78.68 / $369.36 / $1,194.93	Professional		$78.68	$369.36	$1,194.93
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $862.40 / $1,180.54 / $1,275.68	Facility		$862.40	$1,180.54	$1,275.68
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $842.58 / $870.13 / $2,961.46	Facility		$842.58	$870.13	$2,961.46
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $968.00 / $1,384.21 / $1,727.12	Professional		$968.00	$1,384.21	$1,727.12
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 $859.32 / $1,238.52 / $1,648.86	Professional		$859.32	$1,238.52	$1,648.86
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 $752.64 / $1,028.91 / $1,789.79	Professional		$752.64	$1,028.91	$1,789.79
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $530.60 / $530.60 / $692.04	Professional		$530.60	$530.60	$692.04