Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,222.95 / $5,128.00 / $25,871.20	Facility		$1,222.95	$5,128.00	$25,871.20
Aetna Facility/Professional Professional Modifier Low / Median / High Price $618.29 / $872.40 / $1,695.02	Professional		$618.29	$872.40	$1,695.02
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $2,800.00 / $14,160.61 / $21,602.23	Facility		$2,800.00	$14,160.61	$21,602.23
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $951.62 / $1,570.86 / $5,955.23	Professional		$951.62	$1,570.86	$5,955.23
Cigna Facility/Professional Facility Modifier Low / Median / High Price $500.00 / $870.49 / $6,775.01	Facility		$500.00	$870.49	$6,775.01
Cigna Facility/Professional Professional Modifier Low / Median / High Price $681.87 / $1,194.03 / $2,017.98	Professional		$681.87	$1,194.03	$2,017.98
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $751.12 / $1,464.68 / $6,295.23	Facility		$751.12	$1,464.68	$6,295.23
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $628.95 / $1,329.78 / $4,564.68	Professional		$628.95	$1,329.78	$4,564.68
Molina Facility/Professional Professional Modifier Low / Median / High Price $98.76 / $750.01 / $1,507.59	Professional		$98.76	$750.01	$1,507.59
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,083.57 / $1,293.05 / $1,355.41	Facility		$1,083.57	$1,293.05	$1,355.41
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $909.17 / $2,429.53 / $3,875.03	Facility		$909.17	$2,429.53	$3,875.03
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $963.36 / $1,529.41 / $1,845.98	Professional		$963.36	$1,529.41	$1,845.98
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $11,931.42 / $16,351.48 / $31,278.54	Facility		$11,931.42	$16,351.48	$31,278.54
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $1,073.75 / $1,329.92 / $1,749.47	Professional		$1,073.75	$1,329.92	$1,749.47
United Facility/Professional Facility Modifier Low / Median / High Price $1,900.00 / $4,686.00 / $19,271.00	Facility		$1,900.00	$4,686.00	$19,271.00
United Facility/Professional Professional Modifier Low / Median / High Price $760.89 / $1,105.49 / $1,940.65	Professional		$760.89	$1,105.49	$1,940.65
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $561.79 / $711.55 / $711.55	Professional		$561.79	$711.55	$711.55