Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,582.06 / $5,132.00 / $22,024.00	Facility		$1,582.06	$5,132.00	$22,024.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $799.54 / $1,101.28 / $2,324.98	Professional		$799.54	$1,101.28	$2,324.98
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $1,192.31 / $35,815.01 / $70,064.83	Facility		$1,192.31	$35,815.01	$70,064.83
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $1,231.80 / $1,969.97 / $7,594.50	Professional		$1,231.80	$1,969.97	$7,594.50
Cigna Facility/Professional Facility Modifier Low / Median / High Price $765.00 / $870.49 / $870.49	Facility		$765.00	$870.49	$870.49
Cigna Facility/Professional Professional Modifier Low / Median / High Price $886.61 / $1,553.65 / $2,632.86	Professional		$886.61	$1,553.65	$2,632.86
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $816.23 / $1,652.78 / $2,361.01	Facility		$816.23	$1,652.78	$2,361.01
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $816.23 / $1,605.39 / $2,160.73	Professional		$816.23	$1,605.39	$2,160.73
Molina Facility/Professional Professional Modifier Low / Median / High Price $79.72 / $522.45 / $1,700.72	Professional		$79.72	$522.45	$1,700.72
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,162.77 / $1,600.85 / $1,748.03	Facility		$1,162.77	$1,600.85	$1,748.03
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,159.23 / $1,159.23 / $1,192.31	Facility		$1,159.23	$1,159.23	$1,192.31
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,329.97 / $1,896.74 / $2,366.62	Professional		$1,329.97	$1,896.74	$2,366.62
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $27,977.90 / $36,627.79 / $70,064.83	Facility		$27,977.90	$36,627.79	$70,064.83
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $1,182.26 / $1,697.10 / $2,259.39	Professional		$1,182.26	$1,697.10	$2,259.39
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 $1,039.50 / $1,409.90 / $2,499.67	Professional		$1,039.50	$1,409.90	$2,499.67
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $726.06 / $726.06 / $941.42	Professional		$726.06	$726.06	$941.42