Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $792.91 / $3,810.00 / $18,711.00	Facility		$792.91	$3,810.00	$18,711.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $471.24 / $774.77 / $1,497.13	Professional		$471.24	$774.77	$1,497.13
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $1,641.35 / $7,929.30 / $16,394.00	Facility		$1,641.35	$7,929.30	$16,394.00
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $810.03 / $1,356.79 / $5,062.50	Professional		$810.03	$1,356.79	$5,062.50
Cigna Facility/Professional Facility Modifier Low / Median / High Price $625.25 / $761.81 / $3,311.26	Facility		$625.25	$761.81	$3,311.26
Cigna Facility/Professional Professional Modifier Low / Median / High Price $553.86 / $1,010.50 / $1,728.76	Professional		$553.86	$1,010.50	$1,728.76
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $596.55 / $1,133.32 / $3,028.83	Facility		$596.55	$1,133.32	$3,028.83
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $528.79 / $1,086.50 / $2,230.98	Professional		$528.79	$1,086.50	$2,230.98
Molina Facility/Professional Professional Modifier Low / Median / High Price $98.28 / $667.53 / $1,379.33	Professional		$98.28	$667.53	$1,379.33
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $736.96 / $1,040.40 / $1,153.74	Facility		$736.96	$1,040.40	$1,153.74
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $775.99 / $929.09 / $1,915.04	Facility		$775.99	$929.09	$1,915.04
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $818.34 / $1,302.66 / $1,572.30	Professional		$818.34	$1,302.66	$1,572.30
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $5,324.56 / $7,956.97 / $15,220.78	Facility		$5,324.56	$7,956.97	$15,220.78
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $916.46 / $1,132.04 / $1,481.75	Professional		$916.46	$1,132.04	$1,481.75
United Facility/Professional Facility Modifier Low / Median / High Price $1,100.00 / $2,038.00 / $10,522.00	Facility		$1,100.00	$2,038.00	$10,522.00
United Facility/Professional Professional Modifier Low / Median / High Price $574.00 / $941.60 / $1,644.38	Professional		$574.00	$941.60	$1,644.38
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $479.80 / $618.22 / $618.22	Professional		$479.80	$618.22	$618.22