Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,326.31 / $5,128.00 / $20,680.40	Facility		$1,326.31	$5,128.00	$20,680.40
Aetna Facility/Professional Professional Modifier Low / Median / High Price $712.45 / $917.20 / $1,982.86	Professional		$712.45	$917.20	$1,982.86
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $3,478.12 / $9,172.83 / $20,286.13	Facility		$3,478.12	$9,172.83	$20,286.13
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $1,022.65 / $1,666.00 / $6,330.30	Professional		$1,022.65	$1,666.00	$6,330.30
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 $743.72 / $1,293.19 / $2,195.48	Professional		$743.72	$1,293.19	$2,195.48
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $752.55 / $1,520.27 / $3,280.24	Facility		$752.55	$1,520.27	$3,280.24
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $686.81 / $1,481.17 / $2,824.57	Professional		$686.81	$1,481.17	$2,824.57
Molina Facility/Professional Professional Modifier Low / Median / High Price $78.54 / $397.27 / $1,445.59	Professional		$78.54	$397.27	$1,445.59
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,007.44 / $1,356.75 / $1,456.58	Facility		$1,007.44	$1,356.75	$1,456.58
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $962.63 / $986.25 / $2,961.46	Facility		$962.63	$986.25	$2,961.46
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,106.21 / $1,580.50 / $1,972.04	Professional		$1,106.21	$1,580.50	$1,972.04
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 $981.75 / $1,414.15 / $1,882.68	Professional		$981.75	$1,414.15	$1,882.68
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 $882.26 / $1,184.15 / $2,078.71	Professional		$882.26	$1,184.15	$2,078.71
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $605.14 / $605.14 / $786.50	Professional		$605.14	$605.14	$786.50