Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,100.84 / $5,128.00 / $21,917.86	Facility		$1,100.84	$5,128.00	$21,917.86
Aetna Facility/Professional Professional Modifier Low / Median / High Price $550.91 / $761.91 / $1,660.71	Professional		$550.91	$761.91	$1,660.71
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $4,667.63 / $9,172.83 / $20,286.13	Facility		$4,667.63	$9,172.83	$20,286.13
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $831.34 / $1,292.75 / $9,231.33	Professional		$831.34	$1,292.75	$9,231.33
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 $612.07 / $1,073.35 / $1,824.62	Professional		$612.07	$1,073.35	$1,824.62
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $619.00 / $1,253.26 / $3,280.24	Facility		$619.00	$1,253.26	$3,280.24
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $565.72 / $1,216.55 / $2,824.57	Professional		$565.72	$1,216.55	$2,824.57
Molina Facility/Professional Professional Modifier Low / Median / High Price $78.54 / $361.27 / $1,174.82	Professional		$78.54	$361.27	$1,174.82
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $814.93 / $1,126.94 / $1,208.01	Facility		$814.93	$1,126.94	$1,208.01
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $796.37 / $823.97 / $2,961.46	Facility		$796.37	$823.97	$2,961.46
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $916.62 / $1,310.78 / $1,635.50	Professional		$916.62	$1,310.78	$1,635.50
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 $812.20 / $1,172.82 / $1,561.40	Professional		$812.20	$1,172.82	$1,561.40
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 $720.20 / $964.44 / $1,722.46	Professional		$720.20	$964.44	$1,722.46
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $502.45 / $502.45 / $656.60	Professional		$502.45	$502.45	$656.60