Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,361.56 / $6,470.00 / $22,024.00	Facility		$1,361.56	$6,470.00	$22,024.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $683.31 / $940.89 / $2,076.26	Professional		$683.31	$940.89	$2,076.26
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $1,019.57 / $20,273.81 / $38,781.51	Facility		$1,019.57	$20,273.81	$38,781.51
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $1,049.46 / $1,710.00 / $6,494.40	Professional		$1,049.46	$1,710.00	$6,494.40
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 $765.16 / $1,327.55 / $2,251.30	Professional		$765.16	$1,327.55	$2,251.30
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $776.36 / $1,595.37 / $8,743.90	Facility		$776.36	$1,595.37	$8,743.90
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $708.63 / $1,523.95 / $7,730.60	Professional		$708.63	$1,523.95	$7,730.60
Molina Facility/Professional Professional Modifier Low / Median / High Price $78.54 / $397.59 / $1,445.59	Professional		$78.54	$397.59	$1,445.59
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,029.98 / $1,412.36 / $1,494.77	Facility		$1,029.98	$1,412.36	$1,494.77
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $990.26 / $990.26 / $1,019.57	Facility		$990.26	$990.26	$1,019.57
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,136.53 / $1,621.94 / $2,023.74	Professional		$1,136.53	$1,621.94	$2,023.74
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $14,793.48 / $20,273.81 / $38,781.51	Facility		$14,793.48	$20,273.81	$38,781.51
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $1,009.93 / $1,451.22 / $1,946.56	Professional		$1,009.93	$1,451.22	$1,946.56
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 $909.89 / $1,333.09 / $2,101.39	Professional		$909.89	$1,333.09	$2,101.39
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $621.70 / $621.70 / $805.84	Professional		$621.70	$621.70	$805.84