Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $988.00 / $4,500.00 / $21,917.86	Facility		$988.00	$4,500.00	$21,917.86
Aetna Facility/Professional Professional Modifier Low / Median / High Price $545.82 / $798.25 / $1,557.26	Professional		$545.82	$798.25	$1,557.26
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $2,193.67 / $9,558.29 / $26,542.00	Facility		$2,193.67	$9,558.29	$26,542.00
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $876.36 / $1,466.02 / $5,481.68	Professional		$876.36	$1,466.02	$5,481.68
Cigna Facility/Professional Facility Modifier Low / Median / High Price $883.20 / $1,075.31 / $3,991.53	Facility		$883.20	$1,075.31	$3,991.53
Cigna Facility/Professional Professional Modifier Low / Median / High Price $613.47 / $1,097.65 / $1,860.69	Professional		$613.47	$1,097.65	$1,860.69
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $680.62 / $1,272.58 / $3,651.07	Facility		$680.62	$1,272.58	$3,651.07
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $587.00 / $1,228.29 / $2,689.31	Professional		$587.00	$1,228.29	$2,689.31
Molina Facility/Professional Professional Modifier Low / Median / High Price $81.54 / $546.00 / $1,416.44	Professional		$81.54	$546.00	$1,416.44
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $872.20 / $1,138.06 / $1,248.21	Facility		$872.20	$1,138.06	$1,248.21
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $835.79 / $1,460.91 / $2,583.64	Facility		$835.79	$1,460.91	$2,583.64
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $885.60 / $1,406.14 / $1,697.20	Professional		$885.60	$1,406.14	$1,697.20
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $7,069.92 / $9,804.29 / $18,754.53	Facility		$7,069.92	$9,804.29	$18,754.53
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $987.08 / $1,224.74 / $1,605.00	Professional		$987.08	$1,224.74	$1,605.00
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 $677.60 / $1,081.73 / $1,784.26	Professional		$677.60	$1,081.73	$1,784.26
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $517.90 / $658.02 / $658.02	Professional		$517.90	$658.02	$658.02