Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $770.28 / $5,128.00 / $22,024.00	Facility		$770.28	$5,128.00	$22,024.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $543.98 / $770.28 / $984.70	Professional		$543.98	$770.28	$984.70
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $809.06 / $5,897.00 / $9,891.56	Facility		$809.06	$5,897.00	$9,891.56
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $825.13 / $1,425.74 / $5,325.83	Professional		$825.13	$1,425.74	$5,325.83
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,000.00 / $2,285.42 / $2,500.00	Facility		$2,000.00	$2,285.42	$2,500.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $620.89 / $1,084.31 / $1,822.31	Professional		$620.89	$1,084.31	$1,822.31
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $211.97 / $447.61 / $1,292.70	Facility		$211.97	$447.61	$1,292.70
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $222.28 / $543.42 / $1,341.57	Professional		$222.28	$543.42	$1,341.57
Molina Facility/Professional Professional Modifier Low / Median / High Price $39.83 / $351.30 / $597.46	Professional		$39.83	$351.30	$597.46
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $154.32 / $174.26 / $192.90	Facility		$154.32	$174.26	$192.90
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $809.06 / $809.06 / $834.03	Facility		$809.06	$809.06	$834.03
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $929.98 / $1,326.78 / $1,655.46	Professional		$929.98	$1,326.78	$1,655.46
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $825.13 / $1,196.83 / $1,592.80	Professional		$825.13	$1,196.83	$1,592.80
United Facility/Professional Facility Modifier Low / Median / High Price $2,155.00 / $3,297.00 / $11,941.00	Facility		$2,155.00	$3,297.00	$11,941.00
United Facility/Professional Professional Modifier Low / Median / High Price $353.87 / $477.31 / $876.00	Professional		$353.87	$477.31	$876.00
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $191.81 / $191.81 / $718.14	Professional		$191.81	$191.81	$718.14