Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $790.32 / $5,116.62 / $18,800.00	Facility		$790.32	$5,116.62	$18,800.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $610.84 / $806.00 / $1,836.96	Professional		$610.84	$806.00	$1,836.96
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $4,610.06 / $20,273.81 / $38,781.51	Facility		$4,610.06	$20,273.81	$38,781.51
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $880.12 / $1,395.06 / $5,352.53	Professional		$880.12	$1,395.06	$5,352.53
Cigna Facility/Professional Facility Modifier Low / Median / High Price $714.97 / $870.49 / $10,540.05	Facility		$714.97	$870.49	$10,540.05
Cigna Facility/Professional Professional Modifier Low / Median / High Price $729.03 / $1,209.46 / $1,902.72	Professional		$729.03	$1,209.46	$1,902.72
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $702.96 / $1,460.22 / $8,362.11	Facility		$702.96	$1,460.22	$8,362.11
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $698.43 / $1,433.61 / $7,959.30	Professional		$698.43	$1,433.61	$7,959.30
Molina Facility/Professional Professional Modifier Low / Median / High Price $78.68 / $384.31 / $1,289.62	Professional		$78.68	$384.31	$1,289.62
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $896.33 / $1,220.07 / $1,275.01	Facility		$896.33	$1,220.07	$1,275.01
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $819.93 / $855.05 / $8,686.62	Facility		$819.93	$855.05	$8,686.62
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $931.01 / $1,355.92 / $1,697.18	Professional		$931.01	$1,355.92	$1,697.18
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $12,546.63 / $20,262.22 / $38,781.51	Facility		$12,546.63	$20,262.22	$38,781.51
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $836.22 / $1,205.16 / $1,620.29	Professional		$836.22	$1,205.16	$1,620.29
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 $782.90 / $1,003.40 / $1,749.50	Professional		$782.90	$1,003.40	$1,749.50
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $528.39 / $528.39 / $685.97	Professional		$528.39	$528.39	$685.97