Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,002.91 / $4,500.00 / $21,917.86	Facility		$1,002.91	$4,500.00	$21,917.86
Aetna Facility/Professional Professional Modifier Low / Median / High Price $657.22 / $951.22 / $1,891.09	Professional		$657.22	$951.22	$1,891.09
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 $1,057.93 / $1,749.23 / $6,527.48	Professional		$1,057.93	$1,749.23	$6,527.48
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 $747.20 / $1,308.09 / $2,212.26	Professional		$747.20	$1,308.09	$2,212.26
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $811.12 / $1,548.82 / $3,651.07	Facility		$811.12	$1,548.82	$3,651.07
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $695.88 / $1,471.37 / $2,689.31	Professional		$695.88	$1,471.37	$2,689.31
Molina Facility/Professional Professional Modifier Low / Median / High Price $98.48 / $820.42 / $1,723.74	Professional		$98.48	$820.42	$1,723.74
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,023.65 / $1,346.80 / $1,486.06	Facility		$1,023.65	$1,346.80	$1,486.06
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $998.41 / $1,460.91 / $2,583.64	Facility		$998.41	$1,460.91	$2,583.64
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,057.92 / $1,677.78 / $2,025.07	Professional		$1,057.92	$1,677.78	$2,025.07
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 $1,179.14 / $1,458.12 / $1,917.72	Professional		$1,179.14	$1,458.12	$1,917.72
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 $809.79 / $1,260.82 / $2,128.92	Professional		$809.79	$1,260.82	$2,128.92
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $616.46 / $780.17 / $780.17	Professional		$616.46	$780.17	$780.17