Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $944.93 / $2,069.00 / $22,024.00	Facility		$944.93	$2,069.00	$22,024.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $685.76 / $944.93 / $2,069.00	Professional		$685.76	$944.93	$2,069.00
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $1,026.88 / $35,815.01 / $70,064.83	Facility		$1,026.88	$35,815.01	$70,064.83
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $1,056.99 / $1,689.20 / $6,546.08	Professional		$1,056.99	$1,689.20	$6,546.08
Cigna Facility/Professional Facility Modifier Low / Median / High Price $765.00 / $870.49 / $870.49	Facility		$765.00	$870.49	$870.49
Cigna Facility/Professional Professional Modifier Low / Median / High Price $767.93 / $1,332.31 / $2,266.71	Professional		$767.93	$1,332.31	$2,266.71
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $705.87 / $1,421.28 / $2,041.78	Facility		$705.87	$1,421.28	$2,041.78
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $705.87 / $1,417.51 / $1,867.54	Professional		$705.87	$1,417.51	$1,867.54
Molina Facility/Professional Professional Modifier Low / Median / High Price $78.68 / $414.42 / $1,521.65	Professional		$78.68	$414.42	$1,521.65
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,017.45 / $1,407.00 / $1,505.49	Facility		$1,017.45	$1,407.00	$1,505.49
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $995.69 / $995.69 / $1,026.88	Facility		$995.69	$995.69	$1,026.88
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,140.64 / $1,633.57 / $2,038.25	Professional		$1,140.64	$1,633.57	$2,038.25
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $27,977.90 / $36,627.79 / $70,064.83	Facility		$27,977.90	$36,627.79	$70,064.83
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $1,015.48 / $1,461.62 / $1,945.90	Professional		$1,015.48	$1,461.62	$1,945.90
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 $897.56 / $1,192.80 / $2,143.42	Professional		$897.56	$1,192.80	$2,143.42
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $647.10 / $647.10 / $841.79	Professional		$647.10	$647.10	$841.79