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 $561.41 / $786.97 / $1,580.13	Professional		$561.41	$786.97	$1,580.13
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $5,700.71 / $9,032.98 / $23,371.01	Facility		$5,700.71	$9,032.98	$23,371.01
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $799.68 / $1,341.47 / $5,004.75	Professional		$799.68	$1,341.47	$5,004.75
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 $764.55 / $1,124.66 / $1,679.39	Professional		$764.55	$1,124.66	$1,679.39
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $829.92 / $1,356.87 / $6,901.60	Facility		$829.92	$1,356.87	$6,901.60
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $829.92 / $1,313.57 / $2,378.91	Professional		$829.92	$1,313.57	$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 $888.37 / $1,096.55 / $1,250.97	Facility		$888.37	$1,096.55	$1,250.97
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $767.38 / $767.38 / $776.90	Facility		$767.38	$767.38	$776.90
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $816.58 / $1,286.68 / $1,542.07	Professional		$816.58	$1,286.68	$1,542.07
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $5,857.48 / $9,027.82 / $17,279.07	Facility		$5,857.48	$9,027.82	$17,279.07
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $782.63 / $1,117.58 / $1,505.35	Professional		$782.63	$1,117.58	$1,505.35
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 $776.49 / $1,042.84 / $1,737.60	Professional		$776.49	$1,042.84	$1,737.60