Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,242.90 / $5,128.00 / $21,917.86	Facility		$1,242.90	$5,128.00	$21,917.86
Aetna Facility/Professional Professional Modifier Low / Median / High Price $670.98 / $941.38 / $2,589.00	Professional		$670.98	$941.38	$2,589.00
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $2,961.46 / $9,172.83 / $20,286.13	Facility		$2,961.46	$9,172.83	$20,286.13
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $968.30 / $1,545.00 / $5,932.82	Professional		$968.30	$1,545.00	$5,932.82
Cigna Facility/Professional Facility Modifier Low / Median / High Price $883.20 / $1,075.31 / $3,740.43	Facility		$883.20	$1,075.31	$3,740.43
Cigna Facility/Professional Professional Modifier Low / Median / High Price $715.77 / $1,211.85 / $2,052.28	Professional		$715.77	$1,211.85	$2,052.28
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $729.32 / $1,475.49 / $3,280.24	Facility		$729.32	$1,475.49	$3,280.24
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $697.32 / $1,426.72 / $2,824.57	Professional		$697.32	$1,426.72	$2,824.57
Molina Facility/Professional Professional Modifier Low / Median / High Price $78.68 / $384.31 / $1,333.92	Professional		$78.68	$384.31	$1,333.92
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $931.49 / $1,270.99 / $1,358.09	Facility		$931.49	$1,270.99	$1,358.09
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $896.49 / $926.34 / $2,961.46	Facility		$896.49	$926.34	$2,961.46
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,033.77 / $1,473.63 / $1,838.69	Professional		$1,033.77	$1,473.63	$1,838.69
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 $914.30 / $1,318.52 / $1,755.38	Professional		$914.30	$1,318.52	$1,755.38
United Facility/Professional Facility Modifier Low / Median / High Price $2,155.00 / $3,129.00 / $11,941.00	Facility		$2,155.00	$3,129.00	$11,941.00
United Facility/Professional Professional Modifier Low / Median / High Price $825.17 / $1,092.08 / $1,911.40	Professional		$825.17	$1,092.08	$1,911.40
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $566.49 / $566.49 / $739.12	Professional		$566.49	$566.49	$739.12