Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,174.92 / $5,116.62 / $21,917.86	Facility		$1,174.92	$5,116.62	$21,917.86
Aetna Facility/Professional Professional Modifier Low / Median / High Price $535.26 / $812.83 / $1,780.18	Professional		$535.26	$812.83	$1,780.18
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $3,043.20 / $9,172.83 / $20,286.13	Facility		$3,043.20	$9,172.83	$20,286.13
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $901.29 / $1,454.67 / $5,543.63	Professional		$901.29	$1,454.67	$5,543.63
Cigna Facility/Professional Facility Modifier Low / Median / High Price $883.20 / $1,075.31 / $3,740.43	Facility		$883.20	$1,075.31	$3,740.43
Cigna Facility/Professional Professional Modifier Low / Median / High Price $657.90 / $1,145.57 / $1,946.35	Professional		$657.90	$1,145.57	$1,946.35
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $641.19 / $1,315.48 / $3,280.24	Facility		$641.19	$1,315.48	$3,280.24
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $605.77 / $1,300.82 / $2,824.57	Professional		$605.77	$1,300.82	$2,824.57
Molina Facility/Professional Professional Modifier Low / Median / High Price $78.54 / $372.66 / $1,243.05	Professional		$78.54	$372.66	$1,243.05
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $870.65 / $1,203.99 / $1,283.72	Facility		$870.65	$1,203.99	$1,283.72
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $841.67 / $875.61 / $2,961.46	Facility		$841.67	$875.61	$2,961.46
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $974.16 / $1,392.93 / $1,738.00	Professional		$974.16	$1,392.93	$1,738.00
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 $858.40 / $1,246.32 / $1,659.26	Professional		$858.40	$1,246.32	$1,659.26
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 $756.42 / $1,035.41 / $1,782.98	Professional		$756.42	$1,035.41	$1,782.98
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $535.57 / $535.57 / $703.85	Professional		$535.57	$535.57	$703.85