Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,088.96 / $3,925.18 / $18,711.00	Facility		$1,088.96	$3,925.18	$18,711.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $591.76 / $787.63 / $1,685.35	Professional		$591.76	$787.63	$1,685.35
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $5,968.10 / $9,879.37 / $18,898.13	Facility		$5,968.10	$9,879.37	$18,898.13
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $841.55 / $1,463.29 / $5,104.80	Professional		$841.55	$1,463.29	$5,104.80
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 $739.95 / $1,225.34 / $1,809.54	Professional		$739.95	$1,225.34	$1,809.54
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $737.02 / $1,349.48 / $6,254.64	Facility		$737.02	$1,349.48	$6,254.64
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $737.52 / $1,313.25 / $2,641.65	Professional		$737.52	$1,313.25	$2,641.65
Molina Facility/Professional Professional Modifier Low / Median / High Price $99.37 / $693.53 / $1,379.51	Professional		$99.37	$693.53	$1,379.51
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $898.00 / $1,155.24 / $1,265.63	Facility		$898.00	$1,155.24	$1,265.63
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $790.49 / $817.57 / $1,470.05	Facility		$790.49	$817.57	$1,470.05
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $841.55 / $1,362.59 / $1,676.83	Professional		$841.55	$1,362.59	$1,676.83
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $6,079.47 / $9,873.73 / $18,898.13	Facility		$6,079.47	$9,873.73	$18,898.13
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $806.19 / $1,172.57 / $1,584.16	Professional		$806.19	$1,172.57	$1,584.16
United Facility/Professional Facility Modifier Low / Median / High Price $1,550.00 / $2,431.00 / $11,261.00	Facility		$1,550.00	$2,431.00	$11,261.00
United Facility/Professional Professional Modifier Low / Median / High Price $754.17 / $1,255.79 / $1,788.56	Professional		$754.17	$1,255.79	$1,788.56