Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,337.66 / $2,769.52 / $18,711.00	Facility		$1,337.66	$2,769.52	$18,711.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $671.03 / $924.28 / $2,032.96	Professional		$671.03	$924.28	$2,032.96
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $4,346.67 / $9,172.83 / $17,546.59	Facility		$4,346.67	$9,172.83	$17,546.59
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $1,030.48 / $1,672.22 / $6,381.60	Professional		$1,030.48	$1,672.22	$6,381.60
Cigna Facility/Professional Facility Modifier Low / Median / High Price $466.83 / $568.48 / $3,740.43	Facility		$466.83	$568.48	$3,740.43
Cigna Facility/Professional Professional Modifier Low / Median / High Price $751.11 / $1,304.25 / $2,212.98	Professional		$751.11	$1,304.25	$2,212.98
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $761.25 / $1,538.63 / $3,280.24	Facility		$761.25	$1,538.63	$3,280.24
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $693.07 / $1,494.95 / $2,824.57	Professional		$693.07	$1,494.95	$2,824.57
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 $1,025.08 / $1,382.88 / $1,468.64	Facility		$1,025.08	$1,382.88	$1,468.64
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $971.23 / $986.25 / $2,961.46	Facility		$971.23	$986.25	$2,961.46
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,115.97 / $1,593.58 / $1,988.36	Professional		$1,115.97	$1,593.58	$1,988.36
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $6,693.27 / $9,167.59 / $17,546.59	Facility		$6,693.27	$9,167.59	$17,546.59
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $990.53 / $1,425.85 / $1,898.27	Professional		$990.53	$1,425.85	$1,898.27
United Facility/Professional Facility Modifier Low / Median / High Price $1,950.00 / $3,297.00 / $11,941.00	Facility		$1,950.00	$3,297.00	$11,941.00
United Facility/Professional Professional Modifier Low / Median / High Price $875.59 / $1,184.55 / $2,063.40	Professional		$875.59	$1,184.55	$2,063.40
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $610.11 / $610.11 / $792.16	Professional		$610.11	$610.11	$792.16