Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,113.79 / $9,039.78 / $39,431.18	Facility		$1,113.79	$9,039.78	$39,431.18
Aetna Facility/Professional Professional Modifier Low / Median / High Price $566.67 / $966.98 / $3,114.96	Professional		$566.67	$966.98	$3,114.96
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $2,845.24 / $19,823.93 / $38,781.51	Facility		$2,845.24	$19,823.93	$38,781.51
Asuris Northwest Health Facility/Professional Facility Modifier AS Low / Median / High Price $156.61 / $275.97 / $275.97	Facility	AS	$156.61	$275.97	$275.97
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $1,036.08 / $1,955.86 / $7,591.84	Professional		$1,036.08	$1,955.86	$7,591.84
Cigna Facility/Professional Facility Modifier Low / Median / High Price $714.97 / $870.49 / $23,259.60	Facility		$714.97	$870.49	$23,259.60
Cigna Facility/Professional Professional Modifier Low / Median / High Price $761.59 / $1,451.72 / $2,896.87	Professional		$761.59	$1,451.72	$2,896.87
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $732.93 / $1,385.51 / $14,704.36	Facility		$732.93	$1,385.51	$14,704.36
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $732.93 / $1,385.51 / $10,091.16	Professional		$732.93	$1,385.51	$10,091.16
Molina Facility/Professional Professional Modifier Low / Median / High Price $116.38 / $576.09 / $2,004.19	Professional		$116.38	$576.09	$2,004.19
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,147.76 / $1,756.74 / $2,093.08	Facility		$1,147.76	$1,756.74	$2,093.08
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,396.15 / $1,401.62 / $9,547.17	Facility		$1,396.15	$1,401.62	$9,547.17
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,010.33 / $1,561.31 / $2,557.17	Professional		$1,010.33	$1,561.31	$2,557.17
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $13,146.66 / $20,262.22 / $38,781.51	Facility		$13,146.66	$20,262.22	$38,781.51
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $958.25 / $1,482.89 / $2,529.66	Professional		$958.25	$1,482.89	$2,529.66
United Facility/Professional Facility Modifier Low / Median / High Price $2,155.00 / $3,297.00 / $11,941.00	Facility		$2,155.00	$3,297.00	$11,941.00
United Facility/Professional Professional Modifier Low / Median / High Price $1,054.33 / $1,687.40 / $2,962.16	Professional		$1,054.33	$1,687.40	$2,962.16
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $653.40 / $833.17 / $1,124.98	Professional		$653.40	$833.17	$1,124.98