Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $406.70 / $4,500.00 / $17,100.00	Facility		$406.70	$4,500.00	$17,100.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $239.29 / $1,215.78 / $4,477.38	Professional		$239.29	$1,215.78	$4,477.38
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $839.66 / $5,425.50 / $11,041.39	Facility		$839.66	$5,425.50	$11,041.39
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $403.46 / $4,337.76 / $17,432.16	Professional		$403.46	$4,337.76	$17,432.16
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,364.71 / $1,364.71 / $2,273.59	Facility		$1,364.71	$1,364.71	$2,273.59
Cigna Facility/Professional Professional Modifier Low / Median / High Price $346.20 / $728.64 / $7,279.76	Professional		$346.20	$728.64	$7,279.76
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $354.25 / $1,828.65 / $5,050.21	Facility		$354.25	$1,828.65	$5,050.21
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $351.34 / $1,531.84 / $4,045.59	Professional		$351.34	$1,531.84	$4,045.59
Molina Facility/Professional Professional Modifier Low / Median / High Price $178.32 / $690.40 / $5,159.75	Professional		$178.32	$690.40	$5,159.75
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $435.50 / $3,735.55 / $4,749.63	Facility		$435.50	$3,735.55	$4,749.63
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $839.66 / $3,239.67 / $3,361.26	Facility		$839.66	$3,239.67	$3,361.26
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $382.75 / $740.53 / $6,200.47	Professional		$382.75	$740.53	$6,200.47
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $4,102.47 / $5,768.81 / $11,041.39	Facility		$4,102.47	$5,768.81	$11,041.39
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $353.26 / $897.60 / $5,486.89	Professional		$353.26	$897.60	$5,486.89
United Facility/Professional Facility Modifier Low / Median / High Price $879.00 / $1,689.00 / $7,385.00	Facility		$879.00	$1,689.00	$7,385.00
United Facility/Professional Professional Modifier Low / Median / High Price $2,492.26 / $5,105.57 / $6,839.06	Professional		$2,492.26	$5,105.57	$6,839.06