Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $853.44 / $3,810.00 / $18,711.00	Facility		$853.44	$3,810.00	$18,711.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $575.99 / $746.00 / $1,679.41	Professional		$575.99	$746.00	$1,679.41
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $1,140.42 / $8,552.21 / $16,394.00	Facility		$1,140.42	$8,552.21	$16,394.00
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $915.07 / $1,480.30 / $5,386.50	Professional		$915.07	$1,480.30	$5,386.50
Cigna Facility/Professional Facility Modifier Low / Median / High Price $625.25 / $761.81 / $3,302.92	Facility		$625.25	$761.81	$3,302.92
Cigna Facility/Professional Professional Modifier Low / Median / High Price $615.39 / $1,126.58 / $1,900.34	Professional		$615.39	$1,126.58	$1,900.34
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $698.62 / $1,390.94 / $3,021.20	Facility		$698.62	$1,390.94	$3,021.20
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $612.03 / $1,299.67 / $2,225.36	Professional		$612.03	$1,299.67	$2,225.36
Molina Facility/Professional Professional Modifier Low / Median / High Price $98.67 / $726.72 / $1,480.08	Professional		$98.67	$726.72	$1,480.08
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $913.19 / $1,215.68 / $1,254.91	Facility		$913.19	$1,215.68	$1,254.91
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $820.84 / $904.15 / $1,781.59	Facility		$820.84	$904.15	$1,781.59
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $896.24 / $1,419.84 / $1,699.37	Professional		$896.24	$1,419.84	$1,699.37
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $5,916.52 / $9,118.81 / $17,453.22	Facility		$5,916.52	$9,118.81	$17,453.22
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $969.42 / $1,231.31 / $1,608.91	Professional		$969.42	$1,231.31	$1,608.91
United Facility/Professional Facility Modifier Low / Median / High Price $1,100.00 / $2,038.00 / $10,522.00	Facility		$1,100.00	$2,038.00	$10,522.00
United Facility/Professional Professional Modifier Low / Median / High Price $691.86 / $1,064.40 / $1,801.64	Professional		$691.86	$1,064.40	$1,801.64
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $517.63 / $674.23 / $674.23	Professional		$517.63	$674.23	$674.23