Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $783.10 / $4,500.00 / $20,680.40	Facility		$783.10	$4,500.00	$20,680.40
Aetna Facility/Professional Professional Modifier Low / Median / High Price $494.38 / $753.82 / $1,436.39	Professional		$494.38	$753.82	$1,436.39
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $1,790.56 / $7,929.30 / $26,542.00	Facility		$1,790.56	$7,929.30	$26,542.00
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $817.84 / $1,397.17 / $5,210.10	Professional		$817.84	$1,397.17	$5,210.10
Cigna Facility/Professional Facility Modifier Low / Median / High Price $883.20 / $1,075.31 / $3,311.26	Facility		$883.20	$1,075.31	$3,311.26
Cigna Facility/Professional Professional Modifier Low / Median / High Price $555.53 / $1,045.90 / $1,780.82	Professional		$555.53	$1,045.90	$1,780.82
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $614.40 / $1,152.75 / $3,028.83	Facility		$614.40	$1,152.75	$3,028.83
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $533.49 / $1,117.77 / $2,230.98	Professional		$533.49	$1,117.77	$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 $779.59 / $1,069.32 / $1,187.91	Facility		$779.59	$1,069.32	$1,187.91
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $799.09 / $1,208.98 / $1,915.04	Facility		$799.09	$1,208.98	$1,915.04
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $835.90 / $1,342.99 / $1,608.29	Professional		$835.90	$1,342.99	$1,608.29
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 $943.74 / $1,165.57 / $1,512.88	Professional		$943.74	$1,165.57	$1,512.88
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 $609.34 / $958.13 / $1,676.75	Professional		$609.34	$958.13	$1,676.75
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $494.71 / $637.91 / $637.91	Professional		$494.71	$637.91	$637.91