Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,329.66 / $4,011.00 / $18,711.00	Facility		$1,329.66	$4,011.00	$18,711.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $666.93 / $919.69 / $2,028.91	Professional		$666.93	$919.69	$2,028.91
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $4,610.06 / $19,823.93 / $38,781.51	Facility		$4,610.06	$19,823.93	$38,781.51
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $1,024.53 / $1,662.03 / $6,340.43	Professional		$1,024.53	$1,662.03	$6,340.43
Cigna Facility/Professional Facility Modifier Low / Median / High Price $625.25 / $761.81 / $10,565.15	Facility		$625.25	$761.81	$10,565.15
Cigna Facility/Professional Professional Modifier Low / Median / High Price $747.85 / $1,296.45 / $2,199.07	Professional		$747.85	$1,296.45	$2,199.07
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $727.75 / $1,488.42 / $8,382.02	Facility		$727.75	$1,488.42	$8,382.02
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $688.10 / $1,466.87 / $7,978.26	Professional		$688.10	$1,466.87	$7,978.26
Molina Facility/Professional Professional Modifier Low / Median / High Price $78.54 / $397.59 / $1,445.59	Professional		$78.54	$397.59	$1,445.59
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $997.59 / $1,379.53 / $1,459.26	Facility		$997.59	$1,379.53	$1,459.26
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $965.80 / $995.35 / $8,497.21	Facility		$965.80	$995.35	$8,497.21
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,109.29 / $1,583.41 / $1,975.66	Professional		$1,109.29	$1,583.41	$1,975.66
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 $984.98 / $1,416.75 / $1,899.92	Professional		$984.98	$1,416.75	$1,899.92
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 $866.49 / $1,185.31 / $2,051.04	Professional		$866.49	$1,185.31	$2,051.04
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $606.52 / $606.52 / $787.61	Professional		$606.52	$606.52	$787.61