Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,160.61 / $5,128.00 / $21,917.86	Facility		$1,160.61	$5,128.00	$21,917.86
Aetna Facility/Professional Professional Modifier Low / Median / High Price $582.35 / $803.07 / $2,130.73	Professional		$582.35	$803.07	$2,130.73
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $2,701.16 / $4,589.03 / $11,500.00	Facility		$2,701.16	$4,589.03	$11,500.00
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $877.48 / $1,449.72 / $5,540.25	Professional		$877.48	$1,449.72	$5,540.25
Cigna Facility/Professional Facility Modifier Low / Median / High Price $883.20 / $1,075.31 / $1,985.59	Facility		$883.20	$1,075.31	$1,985.59
Cigna Facility/Professional Professional Modifier Low / Median / High Price $628.42 / $1,131.65 / $1,923.31	Professional		$628.42	$1,131.65	$1,923.31
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $615.52 / $1,253.88 / $1,938.75	Facility		$615.52	$1,253.88	$1,938.75
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $597.67 / $1,239.91 / $1,741.30	Professional		$597.67	$1,239.91	$1,741.30
Molina Facility/Professional Professional Modifier Low / Median / High Price $78.68 / $373.32 / $1,231.79	Professional		$78.68	$373.32	$1,231.79
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $854.56 / $1,169.33 / $1,275.01	Facility		$854.56	$1,169.33	$1,275.01
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $537.44 / $840.77 / $1,613.81	Facility		$537.44	$840.77	$1,613.81
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $967.30 / $1,383.48 / $1,726.21	Professional		$967.30	$1,383.48	$1,726.21
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $3,434.81 / $4,589.03 / $8,712.50	Facility		$3,434.81	$4,589.03	$8,712.50
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $857.47 / $1,237.86 / $1,648.00	Professional		$857.47	$1,237.86	$1,648.00
United Facility/Professional Facility Modifier Low / Median / High Price $1,420.06 / $2,240.00 / $11,941.00	Facility		$1,420.06	$2,240.00	$11,941.00
United Facility/Professional Professional Modifier Low / Median / High Price $733.50 / $1,042.83 / $1,780.02	Professional		$733.50	$1,042.83	$1,780.02
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $530.60 / $530.60 / $690.94	Professional		$530.60	$530.60	$690.94