Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,733.00 / $5,128.00 / $21,917.86	Facility		$1,733.00	$5,128.00	$21,917.86
Aetna Facility/Professional Professional Modifier Low / Median / High Price $920.01 / $1,258.83 / $2,810.83	Professional		$920.01	$1,258.83	$2,810.83
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $11,293.38 / $36,469.56 / $71,345.31	Facility		$11,293.38	$36,469.56	$71,345.31
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $1,424.10 / $2,288.05 / $8,734.28	Professional		$1,424.10	$2,288.05	$8,734.28
Cigna Facility/Professional Facility Modifier Low / Median / High Price $883.20 / $1,075.31 / $25,675.26	Facility		$883.20	$1,075.31	$25,675.26
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,043.07 / $1,784.46 / $3,023.35	Professional		$1,043.07	$1,784.46	$3,023.35
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,053.40 / $2,190.28 / $20,369.86	Facility		$1,053.40	$2,190.28	$20,369.86
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $975.00 / $2,074.94 / $19,388.63	Professional		$975.00	$2,074.94	$19,388.63
Molina Facility/Professional Professional Modifier Low / Median / High Price $81.90 / $608.49 / $1,919.55	Professional		$81.90	$608.49	$1,919.55
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,407.77 / $1,914.19 / $2,010.67	Facility		$1,407.77	$1,914.19	$2,010.67
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,334.54 / $1,371.46 / $18,077.87	Facility		$1,334.54	$1,371.46	$18,077.87
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,530.10 / $2,181.73 / $2,722.21	Professional		$1,530.10	$2,181.73	$2,722.21
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $24,749.60 / $37,275.87 / $71,345.31	Facility		$24,749.60	$37,275.87	$71,345.31
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $1,361.05 / $1,952.09 / $2,620.64	Professional		$1,361.05	$1,952.09	$2,620.64
United Facility/Professional Facility Modifier Low / Median / High Price $3,028.00 / $11,540.00 / $19,271.00	Facility		$3,028.00	$11,540.00	$19,271.00
United Facility/Professional Professional Modifier Low / Median / High Price $1,225.19 / $1,621.74 / $2,831.39	Professional		$1,225.19	$1,621.74	$2,831.39
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $836.21 / $836.21 / $1,078.90	Professional		$836.21	$836.21	$1,078.90