Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,345.76 / $4,011.00 / $18,711.00	Facility		$1,345.76	$4,011.00	$18,711.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $710.42 / $1,020.95 / $2,035.41	Professional		$710.42	$1,020.95	$2,035.41
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $2,115.69 / $4,589.03 / $11,500.00	Facility		$2,115.69	$4,589.03	$11,500.00
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $1,029.99 / $1,677.61 / $6,409.13	Professional		$1,029.99	$1,677.61	$6,409.13
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 $750.15 / $1,312.16 / $2,230.02	Professional		$750.15	$1,312.16	$2,230.02
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $744.72 / $1,426.72 / $2,034.92	Facility		$744.72	$1,426.72	$2,034.92
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $693.69 / $1,397.61 / $1,860.77	Professional		$693.69	$1,397.61	$1,860.77
Molina Facility/Professional Professional Modifier Low / Median / High Price $78.68 / $398.50 / $1,419.70	Professional		$78.68	$398.50	$1,419.70
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $998.07 / $1,380.20 / $1,475.34	Facility		$998.07	$1,380.20	$1,475.34
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $537.44 / $973.04 / $1,613.81	Facility		$537.44	$973.04	$1,613.81
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,119.57 / $1,600.85 / $1,997.43	Professional		$1,119.57	$1,600.85	$1,997.43
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $3,434.81 / $4,554.63 / $8,712.50	Facility		$3,434.81	$4,554.63	$8,712.50
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $992.38 / $1,432.35 / $1,906.93	Professional		$992.38	$1,432.35	$1,906.93
United Facility/Professional Facility Modifier Low / Median / High Price $2,408.00 / $5,724.01 / $10,522.00	Facility		$2,408.00	$5,724.01	$10,522.00
United Facility/Professional Professional Modifier Low / Median / High Price $862.16 / $1,186.46 / $2,103.82	Professional		$862.16	$1,186.46	$2,103.82
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $614.25 / $614.25 / $803.98	Professional		$614.25	$614.25	$803.98