Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $801.00 / $5,128.00 / $18,800.00	Facility		$801.00	$5,128.00	$18,800.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $563.76 / $715.81 / $1,498.16	Professional		$563.76	$715.81	$1,498.16
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $6,445.31 / $9,032.98 / $23,371.01	Facility		$6,445.31	$9,032.98	$23,371.01
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $790.02 / $1,333.25 / $6,462.41	Professional		$790.02	$1,333.25	$6,462.41
Cigna Facility/Professional Facility Modifier Low / Median / High Price $3,763.00 / $3,763.00 / $3,763.00	Facility		$3,763.00	$3,763.00	$3,763.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $717.17 / $1,158.08 / $1,696.07	Professional		$717.17	$1,158.08	$1,696.07
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $876.83 / $1,373.75 / $8,977.36	Facility		$876.83	$1,373.75	$8,977.36
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $846.79 / $1,272.69 / $2,378.91	Professional		$846.79	$1,272.69	$2,378.91
Molina Facility/Professional Professional Modifier Low / Median / High Price $67.39 / $725.66 / $1,298.06	Professional		$67.39	$725.66	$1,298.06
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $943.32 / $1,106.94 / $1,311.04	Facility		$943.32	$1,106.94	$1,311.04
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $774.63 / $774.63 / $784.67	Facility		$774.63	$774.63	$784.67
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $824.31 / $1,298.85 / $1,557.49	Professional		$824.31	$1,298.85	$1,557.49
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $6,899.78 / $9,027.82 / $17,279.07	Facility		$6,899.78	$9,027.82	$17,279.07
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $790.02 / $1,128.75 / $1,520.40	Professional		$790.02	$1,128.75	$1,520.40
United Facility/Professional Facility Modifier Low / Median / High Price $2,155.00 / $6,594.00 / $12,835.00	Facility		$2,155.00	$6,594.00	$12,835.00
United Facility/Professional Professional Modifier Low / Median / High Price $724.55 / $1,031.82 / $1,648.10	Professional		$724.55	$1,031.82	$1,648.10