Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,533.60 / $5,128.00 / $20,680.40	Facility		$1,533.60	$5,128.00	$20,680.40
Aetna Facility/Professional Professional Modifier Low / Median / High Price $685.77 / $1,112.02 / $2,236.83	Professional		$685.77	$1,112.02	$2,236.83
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 $1,188.77 / $1,964.01 / $7,418.55	Professional		$1,188.77	$1,964.01	$7,418.55
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 $836.03 / $1,545.06 / $2,614.67	Professional		$836.03	$1,545.06	$2,614.67
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $829.11 / $1,693.83 / $3,280.24	Facility		$829.11	$1,693.83	$3,280.24
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $767.23 / $1,622.78 / $2,824.57	Professional		$767.23	$1,622.78	$2,824.57
Molina Facility/Professional Professional Modifier Low / Median / High Price $116.13 / $474.14 / $1,672.64	Professional		$116.13	$474.14	$1,672.64
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,107.08 / $1,510.18 / $1,707.83	Facility		$1,107.08	$1,510.18	$1,707.83
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $986.25 / $1,151.98 / $2,961.46	Facility		$986.25	$1,151.98	$2,961.46
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,310.45 / $1,881.82 / $2,312.19	Professional		$1,310.45	$1,881.82	$2,312.19
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $6,013.44 / $9,167.59 / $17,546.59	Facility		$6,013.44	$9,167.59	$17,546.59
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $1,174.86 / $1,658.08 / $2,207.42	Professional		$1,174.86	$1,658.08	$2,207.42
United Facility/Professional Facility Modifier Low / Median / High Price $3,129.00 / $11,604.61 / $18,561.84	Facility		$3,129.00	$11,604.61	$18,561.84
United Facility/Professional Professional Modifier Low / Median / High Price $977.00 / $1,327.53 / $2,423.44	Professional		$977.00	$1,327.53	$2,423.44
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $702.59 / $702.59 / $934.08	Professional		$702.59	$702.59	$934.08