Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $713.53 / $1,504.84 / $17,100.00	Facility		$713.53	$1,504.84	$17,100.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $500.20 / $713.53 / $1,451.35	Professional		$500.20	$713.53	$1,451.35
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $1,159.36 / $4,554.63 / $11,500.00	Facility		$1,159.36	$4,554.63	$11,500.00
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $750.86 / $1,202.63 / $4,467.75	Professional		$750.86	$1,202.63	$4,467.75
Cigna Facility/Professional Facility Modifier Low / Median / High Price $625.25 / $761.81 / $1,985.59	Facility		$625.25	$761.81	$1,985.59
Cigna Facility/Professional Professional Modifier Low / Median / High Price $534.55 / $974.68 / $1,691.66	Professional		$534.55	$974.68	$1,691.66
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $492.28 / $991.26 / $1,499.41	Facility		$492.28	$991.26	$1,499.41
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $492.28 / $984.20 / $1,490.31	Professional		$492.28	$984.20	$1,490.31
Molina Facility/Professional Professional Modifier Low / Median / High Price $77.42 / $317.53 / $1,135.45	Professional		$77.42	$317.53	$1,135.45
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $730.59 / $1,014.38 / $1,126.94	Facility		$730.59	$1,014.38	$1,126.94
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $537.44 / $736.13 / $1,613.81	Facility		$537.44	$736.13	$1,613.81
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $768.67 / $1,150.48 / $1,422.27	Professional		$768.67	$1,150.48	$1,422.27
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $2,953.48 / $4,552.03 / $8,712.50	Facility		$2,953.48	$4,552.03	$8,712.50
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $741.69 / $1,036.29 / $1,387.31	Professional		$741.69	$1,036.29	$1,387.31
United Facility/Professional Facility Modifier Low / Median / High Price $157.00 / $546.00 / $5,793.00	Facility		$157.00	$546.00	$5,793.00
United Facility/Professional Professional Modifier Low / Median / High Price $632.69 / $880.64 / $1,574.15	Professional		$632.69	$880.64	$1,574.15
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $468.21 / $563.90 / $622.30	Professional		$468.21	$563.90	$622.30