Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $152.81 / $4,837.00 / $22,024.00	Facility		$152.81	$4,837.00	$22,024.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $78.14 / $1,532.57 / $2,861.82	Professional		$78.14	$1,532.57	$2,861.82
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $213.14 / $10,382.23 / $17,722.46	Facility		$213.14	$10,382.23	$17,722.46
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $122.50 / $3,161.50 / $17,923.14	Professional		$122.50	$3,161.50	$17,923.14
Cigna Facility/Professional Facility Modifier Low / Median / High Price $870.49 / $870.49 / $4,761.71	Facility		$870.49	$870.49	$4,761.71
Cigna Facility/Professional Professional Modifier Low / Median / High Price $95.08 / $1,534.56 / $5,184.85	Professional		$95.08	$1,534.56	$5,184.85
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $91.01 / $2,194.48 / $5,235.02	Facility		$91.01	$2,194.48	$5,235.02
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $86.84 / $1,941.22 / $4,976.56	Professional		$86.84	$1,941.22	$4,976.56
Molina Facility/Professional Professional Modifier Low / Median / High Price $592.13 / $3,471.56 / $6,033.99	Professional		$592.13	$3,471.56	$6,033.99
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $262.20 / $3,568.42 / $3,991.19	Facility		$262.20	$3,568.42	$3,991.19
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,433.98 / $2,433.98 / $2,475.65	Facility		$2,433.98	$2,433.98	$2,475.65
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $136.19 / $353.83 / $4,809.41	Professional		$136.19	$353.83	$4,809.41
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $8,504.29 / $13,114.70 / $25,086.94	Facility		$8,504.29	$13,114.70	$25,086.94
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $122.81 / $316.56 / $4,135.64	Professional		$122.81	$316.56	$4,135.64
United Facility/Professional Facility Modifier Low / Median / High Price $2,912.00 / $4,016.00 / $16,315.00	Facility		$2,912.00	$4,016.00	$16,315.00
United Facility/Professional Professional Modifier Low / Median / High Price $2,003.37 / $3,136.03 / $5,279.48	Professional		$2,003.37	$3,136.03	$5,279.48
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $89.95 / $1,769.32 / $2,515.71	Professional		$89.95	$1,769.32	$2,515.71