Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $819.71 / $1,800.96 / $18,711.00	Facility		$819.71	$1,800.96	$18,711.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $484.31 / $819.71 / $1,800.96	Professional		$484.31	$819.71	$1,800.96
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $2,452.23 / $19,823.93 / $38,781.51	Facility		$2,452.23	$19,823.93	$38,781.51
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $872.97 / $1,504.78 / $5,788.32	Professional		$872.97	$1,504.78	$5,788.32
Cigna Facility/Professional Facility Modifier Low / Median / High Price $883.20 / $1,075.31 / $8,315.84	Facility		$883.20	$1,075.31	$8,315.84
Cigna Facility/Professional Professional Modifier Low / Median / High Price $584.94 / $1,084.76 / $2,213.80	Professional		$584.94	$1,084.76	$2,213.80
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $567.03 / $1,064.91 / $6,166.72	Facility		$567.03	$1,064.91	$6,166.72
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $567.03 / $1,061.68 / $3,607.82	Professional		$567.03	$1,061.68	$3,607.82
Molina Facility/Professional Professional Modifier Low / Median / High Price $108.82 / $422.13 / $1,535.56	Professional		$108.82	$422.13	$1,535.56
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $840.49 / $1,297.48 / $1,585.22	Facility		$840.49	$1,297.48	$1,585.22
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,061.38 / $1,081.26 / $6,526.97	Facility		$1,061.38	$1,081.26	$6,526.97
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $866.98 / $1,279.99 / $1,871.39	Professional		$866.98	$1,279.99	$1,871.39
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 $710.56 / $1,138.11 / $1,762.17	Professional		$710.56	$1,138.11	$1,762.17
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 $769.70 / $1,038.19 / $2,241.05	Professional		$769.70	$1,038.19	$2,241.05
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $576.70 / $652.07 / $878.99	Professional		$576.70	$652.07	$878.99