Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,329.46 / $5,128.00 / $20,680.40	Facility		$1,329.46	$5,128.00	$20,680.40
Aetna Facility/Professional Professional Modifier Low / Median / High Price $691.93 / $909.42 / $2,181.60	Professional		$691.93	$909.42	$2,181.60
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $2,961.46 / $9,172.83 / $20,286.13	Facility		$2,961.46	$9,172.83	$20,286.13
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $1,023.12 / $1,668.31 / $6,113.85	Professional		$1,023.12	$1,668.31	$6,113.85
Cigna Facility/Professional Facility Modifier Low / Median / High Price $714.97 / $870.49 / $3,740.43	Facility		$714.97	$870.49	$3,740.43
Cigna Facility/Professional Professional Modifier Low / Median / High Price $771.68 / $1,333.23 / $2,202.00	Professional		$771.68	$1,333.23	$2,202.00
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $712.07 / $1,529.44 / $2,967.52	Facility		$712.07	$1,529.44	$2,967.52
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $712.07 / $1,498.24 / $2,806.97	Professional		$712.07	$1,498.24	$2,806.97
Molina Facility/Professional Professional Modifier Low / Median / High Price $78.02 / $390.37 / $1,434.95	Professional		$78.02	$390.37	$1,434.95
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,059.59 / $1,432.98 / $1,487.40	Facility		$1,059.59	$1,432.98	$1,487.40
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $963.53 / $986.25 / $2,961.46	Facility		$963.53	$986.25	$2,961.46
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,103.64 / $1,581.23 / $1,972.94	Professional		$1,103.64	$1,581.23	$1,972.94
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 $982.67 / $1,417.77 / $1,883.55	Professional		$982.67	$1,417.77	$1,883.55
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 $897.00 / $1,232.49 / $2,103.73	Professional		$897.00	$1,232.49	$2,103.73
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $604.03 / $604.03 / $769.08	Professional		$604.03	$604.03	$769.08