Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $775.03 / $2,291.00 / $18,711.00	Facility		$775.03	$2,291.00	$18,711.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $502.39 / $711.04 / $1,475.33	Professional		$502.39	$711.04	$1,475.33
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $741.11 / $9,388.90 / $18,898.13	Facility		$741.11	$9,388.90	$18,898.13
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $781.33 / $1,366.18 / $4,721.70	Professional		$781.33	$1,366.18	$4,721.70
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,353.44 / $2,353.44 / $3,920.80	Facility		$2,353.44	$2,353.44	$3,920.80
Cigna Facility/Professional Professional Modifier Low / Median / High Price $728.73 / $1,138.14 / $1,669.80	Professional		$728.73	$1,138.14	$1,669.80
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $694.31 / $1,295.98 / $3,140.04	Facility		$694.31	$1,295.98	$3,140.04
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $697.03 / $1,246.54 / $2,641.65	Professional		$697.03	$1,246.54	$2,641.65
Molina Facility/Professional Professional Modifier Low / Median / High Price $135.10 / $861.24 / $1,414.09	Professional		$135.10	$861.24	$1,414.09
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $798.70 / $1,084.08 / $1,112.86	Facility		$798.70	$1,084.08	$1,112.86
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $741.11 / $759.08 / $1,470.05	Facility		$741.11	$759.08	$1,470.05
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $781.33 / $1,266.18 / $1,556.86	Professional		$781.33	$1,266.18	$1,556.86
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $6,079.47 / $9,660.15 / $18,898.13	Facility		$6,079.47	$9,660.15	$18,898.13
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $755.83 / $1,091.94 / $1,470.82	Professional		$755.83	$1,091.94	$1,470.82
United Facility/Professional Facility Modifier Low / Median / High Price $591.00 / $1,106.00 / $4,911.00	Facility		$591.00	$1,106.00	$4,911.00
United Facility/Professional Professional Modifier Low / Median / High Price $717.64 / $1,076.97 / $1,590.22	Professional		$717.64	$1,076.97	$1,590.22