Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,772.26 / $10,122.46 / $25,998.64	Facility		$1,772.26	$10,122.46	$25,998.64
Aetna Facility/Professional Professional Modifier Low / Median / High Price $951.15 / $1,342.35 / $2,696.54	Professional		$951.15	$1,342.35	$2,696.54
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $8,497.21 / $20,273.81 / $38,781.51	Facility		$8,497.21	$20,273.81	$38,781.51
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $1,368.83 / $2,231.15 / $8,456.40	Professional		$1,368.83	$2,231.15	$8,456.40
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,005.16 / $1,223.70 / $11,327.14	Facility		$1,005.16	$1,223.70	$11,327.14
Cigna Facility/Professional Professional Modifier Low / Median / High Price $997.33 / $1,728.00 / $2,931.88	Professional		$997.33	$1,728.00	$2,931.88
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,012.43 / $2,095.39 / $9,933.52	Facility		$1,012.43	$2,095.39	$9,933.52
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $950.82 / $2,006.71 / $8,553.67	Professional		$950.82	$2,006.71	$8,553.67
Molina Facility/Professional Professional Modifier Low / Median / High Price $81.78 / $601.44 / $1,877.39	Professional		$81.78	$601.44	$1,877.39
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,338.68 / $1,831.11 / $1,946.35	Facility		$1,338.68	$1,831.11	$1,946.35
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,288.33 / $1,327.59 / $8,497.21	Facility		$1,288.33	$1,327.59	$8,497.21
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,479.23 / $2,111.94 / $2,635.13	Professional		$1,479.23	$2,111.94	$2,635.13
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $13,146.66 / $20,262.22 / $38,781.51	Facility		$13,146.66	$20,262.22	$38,781.51
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $1,313.93 / $1,889.64 / $2,533.52	Professional		$1,313.93	$1,889.64	$2,533.52
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 $1,185.08 / $1,520.55 / $2,735.04	Professional		$1,185.08	$1,520.55	$2,735.04
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $808.60 / $808.60 / $1,048.88	Professional		$808.60	$808.60	$1,048.88