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 $501.16 / $674.97 / $1,418.11	Professional		$501.16	$674.97	$1,418.11
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $715.29 / $8,832.54 / $17,279.07	Facility		$715.29	$8,832.54	$17,279.07
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $742.34 / $1,261.02 / $4,669.88	Professional		$742.34	$1,261.02	$4,669.88
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 $674.20 / $1,054.92 / $1,580.72	Professional		$674.20	$1,054.92	$1,580.72
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $752.48 / $1,270.04 / $3,300.02	Facility		$752.48	$1,270.04	$3,300.02
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $752.48 / $1,196.16 / $2,378.91	Professional		$752.48	$1,196.16	$2,378.91
Molina Facility/Professional Professional Modifier Low / Median / High Price $52.78 / $662.97 / $1,172.41	Professional		$52.78	$662.97	$1,172.41
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $820.67 / $1,000.00 / $1,078.70	Facility		$820.67	$1,000.00	$1,078.70
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $715.29 / $715.29 / $726.63	Facility		$715.29	$715.29	$726.63
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $769.26 / $1,212.10 / $1,450.75	Professional		$769.26	$1,212.10	$1,450.75
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $5,700.71 / $8,832.54 / $17,279.07	Facility		$5,700.71	$8,832.54	$17,279.07
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $729.50 / $1,045.27 / $1,407.95	Professional		$729.50	$1,045.27	$1,407.95
United Facility/Professional Facility Modifier Low / Median / High Price $648.00 / $1,875.00 / $4,911.00	Facility		$648.00	$1,875.00	$4,911.00
United Facility/Professional Professional Modifier Low / Median / High Price $672.17 / $933.82 / $1,538.03	Professional		$672.17	$933.82	$1,538.03