Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $940.48 / $2,040.65 / $22,024.00	Facility		$940.48	$2,040.65	$22,024.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $682.97 / $940.48 / $2,040.65	Professional		$682.97	$940.48	$2,040.65
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $1,018.65 / $35,815.01 / $70,064.83	Facility		$1,018.65	$35,815.01	$70,064.83
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $1,054.40 / $1,682.35 / $6,488.85	Professional		$1,054.40	$1,682.35	$6,488.85
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 $764.79 / $1,326.94 / $2,249.23	Professional		$764.79	$1,326.94	$2,249.23
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $698.43 / $1,360.25 / $2,020.26	Facility		$698.43	$1,360.25	$2,020.26
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $698.43 / $1,317.28 / $1,849.05	Professional		$698.43	$1,317.28	$1,849.05
Molina Facility/Professional Professional Modifier Low / Median / High Price $78.54 / $397.59 / $1,445.59	Professional		$78.54	$397.59	$1,445.59
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,029.49 / $1,386.90 / $1,493.43	Facility		$1,029.49	$1,386.90	$1,493.43
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $988.90 / $988.90 / $1,018.65	Facility		$988.90	$988.90	$1,018.65
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,136.01 / $1,620.48 / $2,021.93	Professional		$1,136.01	$1,620.48	$2,021.93
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 $1,008.55 / $1,449.92 / $1,930.31	Professional		$1,008.55	$1,449.92	$1,930.31
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 $879.84 / $1,204.55 / $2,100.46	Professional		$879.84	$1,204.55	$2,100.46
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $621.16 / $621.16 / $805.10	Professional		$621.16	$621.16	$805.10