Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,944.87 / $5,132.00 / $22,024.00	Facility		$1,944.87	$5,132.00	$22,024.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,423.85 / $1,944.87 / $4,399.03	Professional		$1,423.85	$1,944.87	$4,399.03
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $2,110.88 / $37,275.87 / $71,345.31	Facility		$2,110.88	$37,275.87	$71,345.31
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $2,199.46 / $3,539.00 / $13,413.53	Professional		$2,199.46	$3,539.00	$13,413.53
Cigna Facility/Professional Facility Modifier Low / Median / High Price $714.97 / $870.49 / $21,325.17	Facility		$714.97	$870.49	$21,325.17
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,656.50 / $2,751.80 / $4,646.26	Professional		$1,656.50	$2,751.80	$4,646.26
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,718.74 / $3,478.18 / $18,701.46	Facility		$1,718.74	$3,478.18	$18,701.46
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,697.02 / $3,267.61 / $16,103.66	Professional		$1,697.02	$3,267.61	$16,103.66
Molina Facility/Professional Professional Modifier Low / Median / High Price $157.08 / $894.56 / $3,055.40	Professional		$157.08	$894.56	$3,055.40
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $2,166.19 / $2,995.57 / $3,094.73	Facility		$2,166.19	$2,995.57	$3,094.73
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,061.15 / $2,110.88 / $17,998.83	Facility		$2,061.15	$2,110.88	$17,998.83
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $2,362.44 / $3,367.00 / $4,189.89	Professional		$2,362.44	$3,367.00	$4,189.89
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $27,215.17 / $37,275.87 / $71,345.31	Facility		$27,215.17	$37,275.87	$71,345.31
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $2,102.10 / $3,021.11 / $4,046.24	Professional		$2,102.10	$3,021.11	$4,046.24
United Facility/Professional Facility Modifier Low / Median / High Price $3,340.00 / $9,089.00 / $25,733.64	Facility		$3,340.00	$9,089.00	$25,733.64
United Facility/Professional Professional Modifier Low / Median / High Price $1,916.04 / $2,589.12 / $4,439.35	Professional		$1,916.04	$2,589.12	$4,439.35
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,286.48 / $1,286.48 / $1,650.47	Professional		$1,286.48	$1,286.48	$1,650.47