Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $915.18 / $3,810.00 / $18,711.00	Facility		$915.18	$3,810.00	$18,711.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $578.59 / $872.99 / $1,721.68	Professional		$578.59	$872.99	$1,721.68
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $2,193.67 / $9,558.29 / $16,394.00	Facility		$2,193.67	$9,558.29	$16,394.00
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $951.62 / $1,616.44 / $5,954.33	Professional		$951.62	$1,616.44	$5,954.33
Cigna Facility/Professional Facility Modifier Low / Median / High Price $625.25 / $761.81 / $3,991.53	Facility		$625.25	$761.81	$3,991.53
Cigna Facility/Professional Professional Modifier Low / Median / High Price $669.96 / $1,181.09 / $2,018.65	Professional		$669.96	$1,181.09	$2,018.65
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $699.37 / $1,380.09 / $3,651.07	Facility		$699.37	$1,380.09	$3,651.07
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $617.66 / $1,272.89 / $2,689.31	Professional		$617.66	$1,272.89	$2,689.31
Molina Facility/Professional Professional Modifier Low / Median / High Price $98.67 / $758.39 / $1,534.97	Professional		$98.67	$758.39	$1,534.97
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $892.44 / $1,212.06 / $1,355.41	Facility		$892.44	$1,212.06	$1,355.41
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $909.62 / $1,460.91 / $2,583.64	Facility		$909.62	$1,460.91	$2,583.64
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $963.84 / $1,530.17 / $1,846.90	Professional		$963.84	$1,530.17	$1,846.90
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $6,718.33 / $9,804.29 / $18,754.53	Facility		$6,718.33	$9,804.29	$18,754.53
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $1,074.28 / $1,329.92 / $1,737.76	Professional		$1,074.28	$1,329.92	$1,737.76
United Facility/Professional Facility Modifier Low / Median / High Price $1,300.00 / $2,759.00 / $11,941.00	Facility		$1,300.00	$2,759.00	$11,941.00
United Facility/Professional Professional Modifier Low / Median / High Price $739.09 / $1,167.00 / $1,941.62	Professional		$739.09	$1,167.00	$1,941.62
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $561.79 / $712.01 / $712.01	Professional		$561.79	$712.01	$712.01