Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,125.00 / $5,132.00 / $22,024.00	Facility		$1,125.00	$5,132.00	$22,024.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $607.00 / $826.65 / $1,734.10	Professional		$607.00	$826.65	$1,734.10
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $8,347.34 / $36,469.56 / $71,345.31	Facility		$8,347.34	$36,469.56	$71,345.31
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $919.63 / $1,473.86 / $5,690.18	Professional		$919.63	$1,473.86	$5,690.18
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,005.16 / $1,223.70 / $22,081.59	Facility		$1,005.16	$1,223.70	$22,081.59
Cigna Facility/Professional Professional Modifier Low / Median / High Price $667.39 / $1,163.75 / $1,975.13	Professional		$667.39	$1,163.75	$1,975.13
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $678.65 / $1,385.93 / $17,518.77	Facility		$678.65	$1,385.93	$17,518.77
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $616.10 / $1,328.92 / $16,674.87	Professional		$616.10	$1,328.92	$16,674.87
Molina Facility/Professional Professional Modifier Low / Median / High Price $78.68 / $373.32 / $1,254.92	Professional		$78.68	$373.32	$1,254.92
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $900.69 / $1,228.10 / $1,309.84	Facility		$900.69	$1,228.10	$1,309.84
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $867.04 / $893.44 / $19,429.20	Facility		$867.04	$893.44	$19,429.20
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $995.23 / $1,421.29 / $1,773.38	Professional		$995.23	$1,421.29	$1,773.38
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $24,749.60 / $37,275.87 / $71,345.31	Facility		$24,749.60	$37,275.87	$71,345.31
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $884.27 / $1,271.69 / $1,704.56	Professional		$884.27	$1,271.69	$1,704.56
United Facility/Professional Facility Modifier Low / Median / High Price $2,912.00 / $4,016.00 / $16,315.00	Facility		$2,912.00	$4,016.00	$16,315.00
United Facility/Professional Professional Modifier Low / Median / High Price $775.32 / $1,065.35 / $1,948.63	Professional		$775.32	$1,065.35	$1,948.63
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $544.96 / $544.96 / $708.63	Professional		$544.96	$544.96	$708.63