Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,287.85 / $5,128.00 / $20,680.40	Facility		$1,287.85	$5,128.00	$20,680.40
Aetna Facility/Professional Professional Modifier Low / Median / High Price $692.88 / $974.53 / $2,172.94	Professional		$692.88	$974.53	$2,172.94
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 $991.13 / $1,614.00 / $6,132.30	Professional		$991.13	$1,614.00	$6,132.30
Cigna Facility/Professional Facility Modifier Low / Median / High Price $714.97 / $870.49 / $3,740.43	Facility		$714.97	$870.49	$3,740.43
Cigna Facility/Professional Professional Modifier Low / Median / High Price $716.48 / $1,255.71 / $2,130.96	Professional		$716.48	$1,255.71	$2,130.96
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $730.36 / $1,479.39 / $3,280.24	Facility		$730.36	$1,479.39	$3,280.24
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $665.53 / $1,432.60 / $2,824.57	Professional		$665.53	$1,432.60	$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 $956.48 / $1,306.50 / $1,411.69	Facility		$956.48	$1,306.50	$1,411.69
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $932.73 / $962.90 / $2,961.46	Facility		$932.73	$962.90	$2,961.46
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,072.81 / $1,531.79 / $1,911.26	Professional		$1,072.81	$1,531.79	$1,911.26
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 $951.26 / $1,370.56 / $1,824.66	Professional		$951.26	$1,370.56	$1,824.66
United Facility/Professional Facility Modifier Low / Median / High Price $1,950.00 / $3,492.00 / $11,941.00	Facility		$1,950.00	$3,492.00	$11,941.00
United Facility/Professional Professional Modifier Low / Median / High Price $832.00 / $1,143.19 / $1,979.88	Professional		$832.00	$1,143.19	$1,979.88
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $587.75 / $587.75 / $766.32	Professional		$587.75	$587.75	$766.32