Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,162.35 / $5,128.00 / $20,680.40	Facility		$1,162.35	$5,128.00	$20,680.40
Aetna Facility/Professional Professional Modifier Low / Median / High Price $533.91 / $807.23 / $1,690.89	Professional		$533.91	$807.23	$1,690.89
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $2,961.46 / $9,526.26 / $20,286.13	Facility		$2,961.46	$9,526.26	$20,286.13
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $894.70 / $1,457.00 / $5,536.20	Professional		$894.70	$1,457.00	$5,536.20
Cigna Facility/Professional Facility Modifier Low / Median / High Price $714.97 / $870.49 / $4,740.89	Facility		$714.97	$870.49	$4,740.89
Cigna Facility/Professional Professional Modifier Low / Median / High Price $651.12 / $1,133.33 / $1,923.31	Professional		$651.12	$1,133.33	$1,923.31
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $657.72 / $1,331.70 / $4,157.60	Facility		$657.72	$1,331.70	$4,157.60
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $601.39 / $1,294.84 / $3,580.06	Professional		$601.39	$1,294.84	$3,580.06
Molina Facility/Professional Professional Modifier Low / Median / High Price $78.68 / $368.70 / $1,194.93	Professional		$78.68	$368.70	$1,194.93
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $876.61 / $1,197.96 / $1,274.33	Facility		$876.61	$1,197.96	$1,274.33
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $843.49 / $869.21 / $2,961.46	Facility		$843.49	$869.21	$2,961.46
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $968.51 / $1,382.75 / $1,725.30	Professional		$968.51	$1,382.75	$1,725.30
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $7,006.61 / $9,347.69 / $17,546.59	Facility		$7,006.61	$9,347.69	$17,546.59
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $860.24 / $1,237.21 / $1,647.13	Professional		$860.24	$1,237.21	$1,647.13
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 $738.00 / $1,007.99 / $1,819.96	Professional		$738.00	$1,007.99	$1,819.96
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $529.50 / $529.50 / $690.18	Professional		$529.50	$529.50	$690.18