Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,250.64 / $5,128.00 / $20,680.40	Facility		$1,250.64	$5,128.00	$20,680.40
Aetna Facility/Professional Professional Modifier Low / Median / High Price $648.63 / $894.47 / $1,882.53	Professional		$648.63	$894.47	$1,882.53
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $3,478.12 / $9,522.34 / $20,286.13	Facility		$3,478.12	$9,522.34	$20,286.13
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $997.10 / $1,627.01 / $6,164.10	Professional		$997.10	$1,627.01	$6,164.10
Cigna Facility/Professional Facility Modifier Low / Median / High Price $714.97 / $870.49 / $4,859.96	Facility		$714.97	$870.49	$4,859.96
Cigna Facility/Professional Professional Modifier Low / Median / High Price $723.37 / $1,261.65 / $2,140.06	Professional		$723.37	$1,261.65	$2,140.06
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $668.59 / $1,441.30 / $4,262.02	Facility		$668.59	$1,441.30	$4,262.02
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $662.47 / $1,386.63 / $3,669.99	Professional		$662.47	$1,386.63	$3,669.99
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 $949.13 / $1,318.74 / $1,419.06	Facility		$949.13	$1,318.74	$1,419.06
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $939.52 / $967.93 / $2,961.46	Facility		$939.52	$967.93	$2,961.46
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,078.77 / $1,539.79 / $1,921.24	Professional		$1,078.77	$1,539.79	$1,921.24
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $5,948.17 / $9,167.59 / $17,546.59	Facility		$5,948.17	$9,167.59	$17,546.59
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $958.19 / $1,377.72 / $1,834.19	Professional		$958.19	$1,377.72	$1,834.19
United Facility/Professional Facility Modifier Low / Median / High Price $1,547.00 / $2,408.00 / $10,522.00	Facility		$1,547.00	$2,408.00	$10,522.00
United Facility/Professional Professional Modifier Low / Median / High Price $795.56 / $1,083.77 / $1,995.00	Professional		$795.56	$1,083.77	$1,995.00
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $590.51 / $590.51 / $768.07	Professional		$590.51	$590.51	$768.07