Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $947.52 / $5,128.00 / $20,680.40	Facility		$947.52	$5,128.00	$20,680.40
Aetna Facility/Professional Professional Modifier Low / Median / High Price $519.60 / $726.31 / $1,757.24	Professional		$519.60	$726.31	$1,757.24
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $2,868.32 / $19,913.50 / $38,781.51	Facility		$2,868.32	$19,913.50	$38,781.51
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $728.97 / $1,115.92 / $4,548.79	Professional		$728.97	$1,115.92	$4,548.79
Cigna Facility/Professional Facility Modifier Low / Median / High Price $714.97 / $2,285.42 / $8,315.84	Facility		$714.97	$2,285.42	$8,315.84
Cigna Facility/Professional Professional Modifier Low / Median / High Price $591.21 / $986.57 / $1,576.32	Professional		$591.21	$986.57	$1,576.32
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $672.24 / $1,310.76 / $7,292.72	Facility		$672.24	$1,310.76	$7,292.72
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $661.15 / $1,212.23 / $6,279.70	Professional		$661.15	$1,212.23	$6,279.70
Molina Facility/Professional Professional Modifier Low / Median / High Price $73.20 / $290.73 / $1,037.06	Professional		$73.20	$290.73	$1,037.06
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $853.60 / $1,024.83 / $1,317.67	Facility		$853.60	$1,024.83	$1,317.67
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $683.12 / $709.26 / $8,612.89	Facility		$683.12	$709.26	$8,612.89
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $784.57 / $1,128.30 / $1,407.82	Professional		$784.57	$1,128.30	$1,407.82
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 $696.70 / $1,009.54 / $1,344.03	Professional		$696.70	$1,009.54	$1,344.03
United Facility/Professional Facility Modifier Low / Median / High Price $2,155.00 / $3,129.00 / $11,941.00	Facility		$2,155.00	$3,129.00	$11,941.00
United Facility/Professional Professional Modifier Low / Median / High Price $641.55 / $908.04 / $1,474.48	Professional		$641.55	$908.04	$1,474.48
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $431.50 / $431.50 / $555.82	Professional		$431.50	$431.50	$555.82