Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $660.49 / $1,476.64 / $17,100.00	Facility		$660.49	$1,476.64	$17,100.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $353.46 / $563.54 / $1,363.97	Professional		$353.46	$563.54	$1,363.97
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $1,660.48 / $9,172.83 / $17,546.59	Facility		$1,660.48	$9,172.83	$17,546.59
Asuris Northwest Health Facility/Professional Facility Modifier AS Low / Median / High Price $91.04 / $160.77 / $160.77	Facility	AS	$91.04	$160.77	$160.77
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $602.63 / $1,014.26 / $3,894.80	Professional		$602.63	$1,014.26	$3,894.80
Cigna Facility/Professional Facility Modifier Low / Median / High Price $625.25 / $761.81 / $3,740.43	Facility		$625.25	$761.81	$3,740.43
Cigna Facility/Professional Professional Modifier Low / Median / High Price $450.20 / $795.02 / $1,492.51	Professional		$450.20	$795.02	$1,492.51
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $441.16 / $828.52 / $2,806.97	Facility		$441.16	$828.52	$2,806.97
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $441.16 / $825.78 / $1,820.53	Professional		$441.16	$825.78	$1,820.53
Molina Facility/Professional Professional Modifier Low / Median / High Price $39.46 / $283.22 / $1,018.50	Professional		$39.46	$283.22	$1,018.50
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $631.20 / $1,016.08 / $1,079.16	Facility		$631.20	$1,016.08	$1,079.16
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $719.78 / $721.18 / $2,961.46	Facility		$719.78	$721.18	$2,961.46
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $596.54 / $882.68 / $1,319.38	Professional		$596.54	$882.68	$1,319.38
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $5,948.17 / $9,167.59 / $17,546.59	Facility		$5,948.17	$9,167.59	$17,546.59
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $559.46 / $854.06 / $1,299.06	Professional		$559.46	$854.06	$1,299.06
United Facility/Professional Facility Modifier Low / Median / High Price $1,547.00 / $2,408.00 / $10,522.00	Facility		$1,547.00	$2,408.00	$10,522.00
United Facility/Professional Professional Modifier Low / Median / High Price $659.50 / $866.88 / $1,531.28	Professional		$659.50	$866.88	$1,531.28
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $383.45 / $428.73 / $577.21	Professional		$383.45	$428.73	$577.21