Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,069.05 / $7,120.22 / $18,800.00	Facility		$1,069.05	$7,120.22	$18,800.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $487.77 / $739.45 / $1,479.56	Professional		$487.77	$739.45	$1,479.56
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 $813.72 / $1,340.00 / $5,091.38	Professional		$813.72	$1,340.00	$5,091.38
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 $594.09 / $1,042.33 / $1,769.26	Professional		$594.09	$1,042.33	$1,769.26
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $602.47 / $1,219.89 / $3,280.24	Facility		$602.47	$1,219.89	$3,280.24
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $549.13 / $1,181.75 / $2,824.57	Professional		$549.13	$1,181.75	$2,824.57
Molina Facility/Professional Professional Modifier Low / Median / High Price $78.02 / $359.18 / $1,150.47	Professional		$78.02	$359.18	$1,150.47
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $796.74 / $1,083.39 / $1,171.83	Facility		$796.74	$1,083.39	$1,171.83
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $773.72 / $799.29 / $2,961.46	Facility		$773.72	$799.29	$2,961.46
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $890.42 / $1,271.52 / $1,586.52	Professional		$890.42	$1,271.52	$1,586.52
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $7,006.61 / $9,172.83 / $17,546.59	Facility		$7,006.61	$9,172.83	$17,546.59
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $789.10 / $1,137.69 / $1,525.04	Professional		$789.10	$1,137.69	$1,525.04
United Facility/Professional Facility Modifier Low / Median / High Price $2,853.00 / $3,600.00 / $19,271.00	Facility		$2,853.00	$3,600.00	$19,271.00
United Facility/Professional Professional Modifier Low / Median / High Price $692.90 / $904.19 / $1,646.36	Professional		$692.90	$904.19	$1,646.36
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $487.26 / $487.26 / $635.99	Professional		$487.26	$487.26	$635.99