Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,042.80 / $5,128.00 / $22,024.00	Facility		$1,042.80	$5,128.00	$22,024.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $481.26 / $712.20 / $1,510.31	Professional		$481.26	$712.20	$1,510.31
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $3,412.56 / $16,547.20 / $26,542.00	Facility		$3,412.56	$16,547.20	$26,542.00
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $820.38 / $1,349.86 / $8,481.71	Professional		$820.38	$1,349.86	$8,481.71
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,005.16 / $1,223.70 / $6,910.09	Facility		$1,005.16	$1,223.70	$6,910.09
Cigna Facility/Professional Professional Modifier Low / Median / High Price $586.89 / $1,043.46 / $1,769.90	Professional		$586.89	$1,043.46	$1,769.90
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $647.39 / $1,214.08 / $6,320.69	Facility		$647.39	$1,214.08	$6,320.69
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $579.70 / $1,195.84 / $4,655.70	Professional		$579.70	$1,195.84	$4,655.70
Molina Facility/Professional Professional Modifier Low / Median / High Price $98.32 / $663.99 / $1,326.44	Professional		$98.32	$663.99	$1,326.44
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $763.91 / $1,040.18 / $1,168.48	Facility		$763.91	$1,040.18	$1,168.48
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $777.80 / $1,994.21 / $3,953.90	Facility		$777.80	$1,994.21	$3,953.90
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $824.16 / $1,321.68 / $1,595.26	Professional		$824.16	$1,321.68	$1,595.26
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $10,761.59 / $16,595.73 / $31,745.76	Facility		$10,761.59	$16,595.73	$31,745.76
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $918.60 / $1,146.51 / $1,510.30	Professional		$918.60	$1,146.51	$1,510.30
United Facility/Professional Facility Modifier Low / Median / High Price $1,400.00 / $3,509.00 / $16,315.00	Facility		$1,400.00	$3,509.00	$16,315.00
United Facility/Professional Professional Modifier Low / Median / High Price $630.40 / $1,002.41 / $1,682.00	Professional		$630.40	$1,002.41	$1,682.00
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $484.50 / $636.15 / $636.15	Professional		$484.50	$636.15	$636.15