Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,271.11 / $5,128.00 / $20,680.40	Facility		$1,271.11	$5,128.00	$20,680.40
Aetna Facility/Professional Professional Modifier Low / Median / High Price $677.53 / $878.18 / $1,917.47	Professional		$677.53	$878.18	$1,917.47
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 $978.43 / $1,589.07 / $6,053.55	Professional		$978.43	$1,589.07	$6,053.55
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 $712.40 / $1,239.36 / $2,100.69	Professional		$712.40	$1,239.36	$2,100.69
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $716.88 / $1,446.84 / $3,280.24	Facility		$716.88	$1,446.84	$3,280.24
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $656.46 / $1,415.92 / $2,824.57	Professional		$656.46	$1,415.92	$2,824.57
Molina Facility/Professional Professional Modifier Low / Median / High Price $78.68 / $384.31 / $1,365.59	Professional		$78.68	$384.31	$1,365.59
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $960.40 / $1,303.15 / $1,393.60	Facility		$960.40	$1,303.15	$1,393.60
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $923.67 / $950.56 / $2,961.46	Facility		$923.67	$950.56	$2,961.46
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,060.48 / $1,512.16 / $1,886.77	Professional		$1,060.48	$1,512.16	$1,886.77
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $6,693.27 / $9,167.59 / $17,546.59	Facility		$6,693.27	$9,167.59	$17,546.59
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $942.02 / $1,353.00 / $1,801.28	Professional		$942.02	$1,353.00	$1,801.28
United Facility/Professional Facility Modifier Low / Median / High Price $2,155.00 / $3,129.00 / $11,941.00	Facility		$2,155.00	$3,129.00	$11,941.00
United Facility/Professional Professional Modifier Low / Median / High Price $827.41 / $1,124.03 / $1,960.80	Professional		$827.41	$1,124.03	$1,960.80
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $579.75 / $579.75 / $753.09	Professional		$579.75	$579.75	$753.09