Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $630.66 / $2,291.00 / $13,750.00	Facility		$630.66	$2,291.00	$13,750.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $316.24 / $520.53 / $1,073.80	Professional		$316.24	$520.53	$1,073.80
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $658.66 / $7,547.82 / $15,403.47	Facility		$658.66	$7,547.82	$15,403.47
Asuris Northwest Health Facility/Professional Facility Modifier AS Low / Median / High Price $88.06 / $154.86 / $154.86	Facility	AS	$88.06	$154.86	$154.86
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $581.22 / $938.71 / $3,560.00	Professional		$581.22	$938.71	$3,560.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $670.00 / $870.49 / $2,846.84	Facility		$670.00	$870.49	$2,846.84
Cigna Facility/Professional Professional Modifier Low / Median / High Price $426.24 / $773.34 / $1,355.98	Professional		$426.24	$773.34	$1,355.98
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $431.73 / $797.39 / $2,136.38	Facility		$431.73	$797.39	$2,136.38
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $431.73 / $788.50 / $1,515.93	Professional		$431.73	$788.50	$1,515.93
Molina Facility/Professional Professional Modifier Low / Median / High Price $60.84 / $199.70 / $892.05	Professional		$60.84	$199.70	$892.05
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $667.58 / $924.98 / $988.72	Facility		$667.58	$924.98	$988.72
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $654.88 / $658.66 / $2,218.36	Facility		$654.88	$658.66	$2,218.36
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $565.95 / $844.27 / $1,196.91	Professional		$565.95	$844.27	$1,196.91
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $5,221.67 / $8,047.87 / $15,403.47	Facility		$5,221.67	$8,047.87	$15,403.47
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $538.91 / $796.60 / $1,178.69	Professional		$538.91	$796.60	$1,178.69
United Facility/Professional Facility Modifier Low / Median / High Price $2,408.00 / $10,236.34 / $16,373.27	Facility		$2,408.00	$10,236.34	$16,373.27
United Facility/Professional Professional Modifier Low / Median / High Price $600.60 / $774.39 / $1,386.46	Professional		$600.60	$774.39	$1,386.46
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $365.67 / $390.09 / $519.57	Professional		$365.67	$390.09	$519.57