Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,335.15 / $5,128.00 / $20,680.40	Facility		$1,335.15	$5,128.00	$20,680.40
Aetna Facility/Professional Professional Modifier Low / Median / High Price $669.71 / $922.72 / $2,028.77	Professional		$669.71	$922.72	$2,028.77
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 $1,028.76 / $1,680.10 / $6,366.60	Professional		$1,028.76	$1,680.10	$6,366.60
Cigna Facility/Professional Facility Modifier Low / Median / High Price $714.97 / $870.49 / $8,315.84	Facility		$714.97	$870.49	$8,315.84
Cigna Facility/Professional Professional Modifier Low / Median / High Price $749.35 / $1,301.81 / $2,208.08	Professional		$749.35	$1,301.81	$2,208.08
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $761.25 / $1,553.65 / $7,292.72	Facility		$761.25	$1,553.65	$7,292.72
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $691.82 / $1,492.05 / $6,279.70	Professional		$691.82	$1,492.05	$6,279.70
Molina Facility/Professional Professional Modifier Low / Median / High Price $78.54 / $397.59 / $1,445.59	Professional		$78.54	$397.59	$1,445.59
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,018.22 / $1,378.19 / $1,465.29	Facility		$1,018.22	$1,378.19	$1,465.29
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $969.42 / $999.46 / $6,526.97	Facility		$969.42	$999.46	$6,526.97
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,113.92 / $1,589.95 / $1,983.83	Professional		$1,113.92	$1,589.95	$1,983.83
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $13,543.50 / $20,262.22 / $38,781.51	Facility		$13,543.50	$20,262.22	$38,781.51
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $988.68 / $1,422.60 / $1,907.84	Professional		$988.68	$1,422.60	$1,907.84
United Facility/Professional Facility Modifier Low / Median / High Price $3,028.00 / $5,547.00 / $19,271.00	Facility		$3,028.00	$5,547.00	$19,271.00
United Facility/Professional Professional Modifier Low / Median / High Price $890.96 / $1,192.39 / $2,051.29	Professional		$890.96	$1,192.39	$2,051.29
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $609.00 / $609.00 / $790.75	Professional		$609.00	$609.00	$790.75