Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $988.00 / $4,500.00 / $21,917.86	Facility		$988.00	$4,500.00	$21,917.86
Aetna Facility/Professional Professional Modifier Low / Median / High Price $575.23 / $794.95 / $1,702.40	Professional		$575.23	$794.95	$1,702.40
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $1,781.59 / $8,921.56 / $26,542.00	Facility		$1,781.59	$8,921.56	$26,542.00
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $879.43 / $1,420.74 / $5,901.04	Professional		$879.43	$1,420.74	$5,901.04
Cigna Facility/Professional Facility Modifier Low / Median / High Price $883.20 / $1,075.31 / $3,302.92	Facility		$883.20	$1,075.31	$3,302.92
Cigna Facility/Professional Professional Modifier Low / Median / High Price $603.63 / $1,107.74 / $1,865.66	Professional		$603.63	$1,107.74	$1,865.66
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $686.25 / $1,387.14 / $3,021.20	Facility		$686.25	$1,387.14	$3,021.20
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $601.08 / $1,291.95 / $2,225.36	Professional		$601.08	$1,291.95	$2,225.36
Molina Facility/Professional Professional Modifier Low / Median / High Price $98.67 / $719.58 / $1,444.86	Professional		$98.67	$719.58	$1,444.86
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $917.28 / $1,191.80 / $1,248.21	Facility		$917.28	$1,191.80	$1,248.21
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $819.02 / $1,140.42 / $1,994.21	Facility		$819.02	$1,140.42	$1,994.21
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $879.43 / $1,393.21 / $1,681.59	Professional		$879.43	$1,393.21	$1,681.59
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $6,812.14 / $9,124.02 / $17,453.22	Facility		$6,812.14	$9,124.02	$17,453.22
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $967.28 / $1,207.64 / $1,589.14	Professional		$967.28	$1,207.64	$1,589.14
United Facility/Professional Facility Modifier Low / Median / High Price $1,648.57 / $2,964.39 / $10,312.00	Facility		$1,648.57	$2,964.39	$10,312.00
United Facility/Professional Professional Modifier Low / Median / High Price $684.44 / $1,105.29 / $1,767.82	Professional		$684.44	$1,105.29	$1,767.82
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $506.59 / $661.73 / $661.73	Professional		$506.59	$661.73	$661.73