Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $698.48 / $9,916.12 / $17,930.00	Facility		$698.48	$9,916.12	$17,930.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $489.51 / $678.39 / $1,340.79	Professional		$489.51	$678.39	$1,340.79
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $5,089.03 / $9,044.98 / $22,922.83	Facility		$5,089.03	$9,044.98	$22,922.83
Asuris Northwest Health Facility/Professional Facility Modifier AS Low / Median / High Price $541.16 / $900.13 / $900.13	Facility	AS	$541.16	$900.13	$900.13
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $815.52 / $1,464.95 / $5,149.95	Professional		$815.52	$1,464.95	$5,149.95
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,380.38 / $2,380.38 / $3,965.68	Facility		$2,380.38	$2,380.38	$3,965.68
Cigna Facility/Professional Professional Modifier Low / Median / High Price $642.27 / $1,204.50 / $1,808.58	Professional		$642.27	$1,204.50	$1,808.58
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $651.45 / $1,116.33 / $5,198.37	Facility		$651.45	$1,116.33	$5,198.37
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $686.15 / $1,101.85 / $2,671.90	Professional		$686.15	$1,101.85	$2,671.90
Molina Facility/Professional Professional Modifier Low / Median / High Price $99.54 / $682.14 / $1,352.24	Professional		$99.54	$682.14	$1,352.24
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $726.67 / $999.64 / $1,193.27	Facility		$726.67	$999.64	$1,193.27
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $793.20 / $813.92 / $1,367.95	Facility		$793.20	$813.92	$1,367.95
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $837.78 / $1,342.99 / $1,669.33	Professional		$837.78	$1,342.99	$1,669.33
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $5,745.15 / $8,854.69 / $16,947.71	Facility		$5,745.15	$8,854.69	$16,947.71
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $808.96 / $1,168.60 / $1,577.08	Professional		$808.96	$1,168.60	$1,577.08
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 $684.56 / $1,114.41 / $1,704.11	Professional		$684.56	$1,114.41	$1,704.11