Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $699.00 / $3,810.00 / $18,711.00	Facility		$699.00	$3,810.00	$18,711.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $355.62 / $532.41 / $1,037.41	Professional		$355.62	$532.41	$1,037.41
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $749.59 / $3,590.15 / $16,394.00	Facility		$749.59	$3,590.15	$16,394.00
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $603.37 / $1,010.66 / $3,777.83	Professional		$603.37	$1,010.66	$3,777.83
Cigna Facility/Professional Facility Modifier Low / Median / High Price $625.25 / $761.81 / $1,499.24	Facility		$625.25	$761.81	$1,499.24
Cigna Facility/Professional Professional Modifier Low / Median / High Price $421.77 / $747.42 / $1,289.35	Professional		$421.77	$747.42	$1,289.35
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $460.80 / $850.55 / $1,491.75	Facility		$460.80	$850.55	$1,491.75
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $398.94 / $830.72 / $1,294.68	Professional		$398.94	$830.72	$1,294.68
Molina Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $399.28 / $1,051.30	Professional		$79.43	$399.28	$1,051.30
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $558.60 / $761.13 / $860.95	Facility		$558.60	$761.13	$860.95
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $574.40 / $587.25 / $929.09	Facility		$574.40	$587.25	$929.09
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $607.38 / $969.39 / $1,170.04	Professional		$607.38	$969.39	$1,170.04
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $2,554.42 / $3,407.94 / $6,397.05	Facility		$2,554.42	$3,407.94	$6,397.05
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $678.38 / $844.43 / $1,103.64	Professional		$678.38	$844.43	$1,103.64
United Facility/Professional Facility Modifier Low / Median / High Price $650.00 / $1,120.00 / $6,857.00	Facility		$650.00	$1,120.00	$6,857.00
United Facility/Professional Professional Modifier Low / Median / High Price $442.00 / $707.63 / $1,230.04	Professional		$442.00	$707.63	$1,230.04
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $357.23 / $459.35 / $459.35	Professional		$357.23	$459.35	$459.35