Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,733.00 / $5,116.62 / $18,800.00	Facility		$1,733.00	$5,116.62	$18,800.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,012.15 / $1,305.14 / $2,710.63	Professional		$1,012.15	$1,305.14	$2,710.63
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $8,562.96 / $26,106.65 / $49,939.07	Facility		$8,562.96	$26,106.65	$49,939.07
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $1,377.12 / $2,300.77 / $8,596.00	Professional		$1,377.12	$2,300.77	$8,596.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $6,795.54 / $6,795.54 / $11,321.29	Facility		$6,795.54	$6,795.54	$11,321.29
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,243.71 / $2,030.00 / $2,988.47	Professional		$1,243.71	$2,030.00	$2,988.47
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,223.96 / $2,268.17 / $10,355.62	Facility		$1,223.96	$2,268.17	$10,355.62
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,233.24 / $2,207.12 / $7,627.76	Professional		$1,233.24	$2,207.12	$7,627.76
Molina Facility/Professional Professional Modifier Low / Median / High Price $150.54 / $1,179.10 / $2,309.96	Professional		$150.54	$1,179.10	$2,309.96
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,461.23 / $1,927.59 / $2,036.92	Facility		$1,461.23	$1,927.59	$2,036.92
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,317.78 / $1,354.09 / $2,173.03	Facility		$1,317.78	$1,354.09	$2,173.03
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,393.80 / $2,258.69 / $2,777.22	Professional		$1,393.80	$2,258.69	$2,777.22
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $16,231.92 / $25,527.34 / $49,939.07	Facility		$16,231.92	$25,527.34	$49,939.07
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $1,343.96 / $1,947.41 / $2,623.74	Professional		$1,343.96	$1,947.41	$2,623.74
United Facility/Professional Facility Modifier Low / Median / High Price $2,155.00 / $3,297.00 / $12,835.00	Facility		$2,155.00	$3,297.00	$12,835.00
United Facility/Professional Professional Modifier Low / Median / High Price $1,265.88 / $2,013.55 / $2,826.99	Professional		$1,265.88	$2,013.55	$2,826.99