Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,045.99 / $5,128.00 / $21,917.86	Facility		$1,045.99	$5,128.00	$21,917.86
Aetna Facility/Professional Professional Modifier Low / Median / High Price $467.25 / $724.84 / $1,551.12	Professional		$467.25	$724.84	$1,551.12
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $1,679.45 / $4,554.63 / $11,500.00	Facility		$1,679.45	$4,554.63	$11,500.00
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $805.80 / $1,285.92 / $4,986.08	Professional		$805.80	$1,285.92	$4,986.08
Cigna Facility/Professional Facility Modifier Low / Median / High Price $883.20 / $1,075.31 / $1,985.59	Facility		$883.20	$1,075.31	$1,985.59
Cigna Facility/Professional Professional Modifier Low / Median / High Price $563.15 / $1,019.87 / $1,739.10	Professional		$563.15	$1,019.87	$1,739.10
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $553.75 / $1,130.77 / $1,816.23	Facility		$553.75	$1,130.77	$1,816.23
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $529.79 / $1,114.43 / $1,621.64	Professional		$529.79	$1,114.43	$1,621.64
Molina Facility/Professional Professional Modifier Low / Median / High Price $77.42 / $313.71 / $1,106.28	Professional		$77.42	$313.71	$1,106.28
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $753.88 / $1,046.54 / $1,147.71	Facility		$753.88	$1,046.54	$1,147.71
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $537.44 / $752.43 / $1,613.81	Facility		$537.44	$752.43	$1,613.81
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $868.15 / $1,245.34 / $1,553.86	Professional		$868.15	$1,245.34	$1,553.86
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $3,323.45 / $4,552.03 / $8,712.50	Facility		$3,323.45	$4,552.03	$8,712.50
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $767.38 / $1,114.28 / $1,483.46	Professional		$767.38	$1,114.28	$1,483.46
United Facility/Professional Facility Modifier Low / Median / High Price $1,436.00 / $5,724.01 / $9,155.68	Facility		$1,436.00	$5,724.01	$9,155.68
United Facility/Professional Professional Modifier Low / Median / High Price $641.29 / $925.70 / $1,605.49	Professional		$641.29	$925.70	$1,605.49
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $630.53 / $630.53 / $630.53	Professional		$630.53	$630.53	$630.53