Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,294.58 / $5,128.00 / $20,680.40	Facility		$1,294.58	$5,128.00	$20,680.40
Aetna Facility/Professional Professional Modifier Low / Median / High Price $648.97 / $896.29 / $1,935.88	Professional		$648.97	$896.29	$1,935.88
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $6,526.97 / $20,273.81 / $38,781.51	Facility		$6,526.97	$20,273.81	$38,781.51
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $997.25 / $1,627.87 / $6,170.93	Professional		$997.25	$1,627.87	$6,170.93
Cigna Facility/Professional Facility Modifier Low / Median / High Price $714.97 / $870.49 / $10,487.68	Facility		$714.97	$870.49	$10,487.68
Cigna Facility/Professional Professional Modifier Low / Median / High Price $725.46 / $1,262.26 / $2,141.88	Professional		$725.46	$1,262.26	$2,141.88
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $732.10 / $1,480.22 / $9,197.34	Facility		$732.10	$1,480.22	$9,197.34
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $669.29 / $1,442.75 / $7,919.75	Professional		$669.29	$1,442.75	$7,919.75
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 $977.55 / $1,323.25 / $1,420.40	Facility		$977.55	$1,323.25	$1,420.40
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $939.98 / $968.84 / $6,526.97	Facility		$939.98	$968.84	$6,526.97
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,079.49 / $1,541.24 / $1,923.05	Professional		$1,079.49	$1,541.24	$1,923.05
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $13,146.66 / $20,262.22 / $38,781.51	Facility		$13,146.66	$20,262.22	$38,781.51
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $958.65 / $1,379.02 / $1,848.88	Professional		$958.65	$1,379.02	$1,848.88
United Facility/Professional Facility Modifier Low / Median / High Price $2,912.00 / $4,016.00 / $16,315.00	Facility		$2,912.00	$4,016.00	$16,315.00
United Facility/Professional Professional Modifier Low / Median / High Price $847.60 / $1,162.90 / $2,028.52	Professional		$847.60	$1,162.90	$2,028.52
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $590.79 / $590.79 / $768.41	Professional		$590.79	$590.79	$768.41