Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,229.99 / $2,736.49 / $22,024.00	Facility		$1,229.99	$2,736.49	$22,024.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $894.25 / $1,229.99 / $2,736.49	Professional		$894.25	$1,229.99	$2,736.49
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $1,331.70 / $46,149.28 / $90,281.73	Facility		$1,331.70	$46,149.28	$90,281.73
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $1,370.75 / $2,202.81 / $8,481.00	Professional		$1,370.75	$2,202.81	$8,481.00
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 $1,013.73 / $1,734.34 / $2,935.10	Professional		$1,013.73	$1,734.34	$2,935.10
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $920.39 / $1,875.76 / $2,662.30	Facility		$920.39	$1,875.76	$2,662.30
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $920.39 / $1,833.25 / $2,441.62	Professional		$920.39	$1,833.25	$2,441.62
Molina Facility/Professional Professional Modifier Low / Median / High Price $81.90 / $608.04 / $1,919.55	Professional		$81.90	$608.04	$1,919.55
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,347.88 / $1,863.94 / $1,952.38	Facility		$1,347.88	$1,863.94	$1,952.38
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,297.84 / $1,297.84 / $1,331.70	Facility		$1,297.84	$1,297.84	$1,331.70
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,487.45 / $2,120.10 / $2,643.29	Professional		$1,487.45	$2,120.10	$2,643.29
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $36,050.80 / $47,196.58 / $90,281.73	Facility		$36,050.80	$47,196.58	$90,281.73
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $1,323.63 / $1,895.50 / $2,523.52	Professional		$1,323.63	$1,895.50	$2,523.52
United Facility/Professional Facility Modifier Low / Median / High Price $3,340.00 / $8,600.00 / $24,236.00	Facility		$3,340.00	$8,600.00	$24,236.00
United Facility/Professional Professional Modifier Low / Median / High Price $1,167.49 / $1,574.73 / $2,795.11	Professional		$1,167.49	$1,574.73	$2,795.11
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $811.91 / $811.91 / $1,046.95	Professional		$811.91	$811.91	$1,046.95