Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,187.93 / $2,769.52 / $18,711.00	Facility		$1,187.93	$2,769.52	$18,711.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $633.20 / $904.81 / $1,736.92	Professional		$633.20	$904.81	$1,736.92
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $2,961.46 / $9,172.83 / $17,546.59	Facility		$2,961.46	$9,172.83	$17,546.59
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $965.75 / $1,585.99 / $5,995.20	Professional		$965.75	$1,585.99	$5,995.20
Cigna Facility/Professional Facility Modifier Low / Median / High Price $466.83 / $568.48 / $3,740.43	Facility		$466.83	$568.48	$3,740.43
Cigna Facility/Professional Professional Modifier Low / Median / High Price $671.61 / $1,252.35 / $2,120.83	Professional		$671.61	$1,252.35	$2,120.83
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $651.19 / $1,338.37 / $3,280.24	Facility		$651.19	$1,338.37	$3,280.24
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $607.02 / $1,288.32 / $2,824.57	Professional		$607.02	$1,288.32	$2,824.57
Molina Facility/Professional Professional Modifier Low / Median / High Price $78.68 / $387.92 / $1,362.78	Professional		$78.68	$387.92	$1,362.78
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $843.78 / $1,198.65 / $1,379.53	Facility		$843.78	$1,198.65	$1,379.53
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $930.92 / $940.96 / $2,961.46	Facility		$930.92	$940.96	$2,961.46
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,058.22 / $1,520.70 / $1,867.72	Professional		$1,058.22	$1,520.70	$1,867.72
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $5,646.13 / $9,167.59 / $17,546.59	Facility		$5,646.13	$9,167.59	$17,546.59
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $949.41 / $1,339.34 / $1,783.09	Professional		$949.41	$1,339.34	$1,783.09
United Facility/Professional Facility Modifier Low / Median / High Price $702.00 / $1,436.00 / $6,857.00	Facility		$702.00	$1,436.00	$6,857.00
United Facility/Professional Professional Modifier Low / Median / High Price $774.00 / $1,072.42 / $1,988.94	Professional		$774.00	$1,072.42	$1,988.94
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $565.39 / $565.39 / $759.76	Professional		$565.39	$565.39	$759.76