Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,125.00 / $5,128.00 / $22,024.00	Facility		$1,125.00	$5,128.00	$22,024.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $585.89 / $854.40 / $1,714.13	Professional		$585.89	$854.40	$1,714.13
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $9,886.41 / $13,486.75 / $21,602.23	Facility		$9,886.41	$13,486.75	$21,602.23
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $934.21 / $1,581.83 / $5,845.05	Professional		$934.21	$1,581.83	$5,845.05
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,005.16 / $1,076.00 / $1,258.00	Facility		$1,005.16	$1,076.00	$1,258.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $666.30 / $1,173.06 / $1,982.39	Professional		$666.30	$1,173.06	$1,982.39
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $725.25 / $1,387.20 / $5,167.68	Facility		$725.25	$1,387.20	$5,167.68
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $625.48 / $1,320.23 / $3,215.17	Professional		$625.48	$1,320.23	$3,215.17
Molina Facility/Professional Professional Modifier Low / Median / High Price $98.49 / $747.39 / $1,506.05	Professional		$98.49	$747.39	$1,506.05
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $926.10 / $1,265.63 / $1,330.62	Facility		$926.10	$1,265.63	$1,330.62
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $890.15 / $890.15 / $907.60	Facility		$890.15	$890.15	$907.60
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $943.20 / $1,498.21 / $1,808.33	Professional		$943.20	$1,498.21	$1,808.33
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 $1,051.27 / $1,305.58 / $1,712.47	Professional		$1,051.27	$1,305.58	$1,712.47
United Facility/Professional Facility Modifier Low / Median / High Price $1,900.05 / $5,176.89 / $12,579.00	Facility		$1,900.05	$5,176.89	$12,579.00
United Facility/Professional Professional Modifier Low / Median / High Price $688.59 / $1,082.95 / $1,901.07	Professional		$688.59	$1,082.95	$1,901.07
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $552.14 / $700.51 / $700.51	Professional		$552.14	$700.51	$700.51