Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $845.65 / $5,128.00 / $18,800.00	Facility		$845.65	$5,128.00	$18,800.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $591.45 / $845.65 / $1,637.86	Professional		$591.45	$845.65	$1,637.86
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $9,749.10 / $16,173.23 / $29,789.77	Facility		$9,749.10	$16,173.23	$29,789.77
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $905.52 / $1,558.04 / $5,822.93	Professional		$905.52	$1,558.04	$5,822.93
Cigna Facility/Professional Facility Modifier Low / Median / High Price $7,128.48 / $7,128.48 / $7,128.48	Facility		$7,128.48	$7,128.48	$7,128.48
Cigna Facility/Professional Professional Modifier Low / Median / High Price $800.83 / $1,316.91 / $1,977.36	Professional		$800.83	$1,316.91	$1,977.36
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $866.81 / $1,355.48 / $7,737.05	Facility		$866.81	$1,355.48	$7,737.05
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $866.81 / $1,346.32 / $4,506.52	Professional		$866.81	$1,346.32	$4,506.52
Molina Facility/Professional Professional Modifier Low / Median / High Price $98.06 / $751.17 / $1,465.89	Professional		$98.06	$751.17	$1,465.89
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $908.95 / $1,238.83 / $1,325.93	Facility		$908.95	$1,238.83	$1,325.93
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $887.88 / $887.88 / $904.40	Facility		$887.88	$887.88	$904.40
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $930.92 / $1,494.41 / $1,795.15	Professional		$930.92	$1,494.41	$1,795.15
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $10,098.52 / $15,564.30 / $29,789.77	Facility		$10,098.52	$15,564.30	$29,789.77
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $905.52 / $1,301.00 / $1,752.40	Professional		$905.52	$1,301.00	$1,752.40
United Facility/Professional Facility Modifier Low / Median / High Price $3,028.00 / $11,540.00 / $20,708.00	Facility		$3,028.00	$11,540.00	$20,708.00
United Facility/Professional Professional Modifier Low / Median / High Price $795.06 / $1,135.81 / $1,874.08	Professional		$795.06	$1,135.81	$1,874.08