Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,203.33 / $5,128.00 / $21,917.86	Facility		$1,203.33	$5,128.00	$21,917.86
Aetna Facility/Professional Professional Modifier Low / Median / High Price $602.84 / $872.69 / $1,817.00	Professional		$602.84	$872.69	$1,817.00
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $4,634.87 / $9,172.83 / $20,286.13	Facility		$4,634.87	$9,172.83	$20,286.13
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $909.17 / $1,413.69 / $6,052.96	Professional		$909.17	$1,413.69	$6,052.96
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 $669.90 / $1,173.29 / $1,993.36	Professional		$669.90	$1,173.29	$1,993.36
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $683.38 / $1,382.60 / $3,280.24	Facility		$683.38	$1,382.60	$3,280.24
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $621.10 / $1,336.90 / $2,824.57	Professional		$621.10	$1,336.90	$2,824.57
Molina Facility/Professional Professional Modifier Low / Median / High Price $78.68 / $384.31 / $1,314.78	Professional		$78.68	$384.31	$1,314.78
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $909.93 / $1,233.47 / $1,320.57	Facility		$909.93	$1,233.47	$1,320.57
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $872.03 / $900.75 / $2,961.46	Facility		$872.03	$900.75	$2,961.46
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,002.42 / $1,432.92 / $1,787.89	Professional		$1,002.42	$1,432.92	$1,787.89
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 $889.35 / $1,282.08 / $1,706.89	Professional		$889.35	$1,282.08	$1,706.89
United Facility/Professional Facility Modifier Low / Median / High Price $3,129.00 / $11,604.61 / $18,561.84	Facility		$3,129.00	$11,604.61	$18,561.84
United Facility/Professional Professional Modifier Low / Median / High Price $787.32 / $1,073.05 / $1,853.45	Professional		$787.32	$1,073.05	$1,853.45
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $549.65 / $549.65 / $716.73	Professional		$549.65	$549.65	$716.73