Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $732.08 / $5,116.62 / $22,024.00	Facility		$732.08	$5,116.62	$22,024.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $486.01 / $568.33 / $935.86	Professional		$486.01	$568.33	$935.86
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $768.29 / $5,897.00 / $9,392.60	Facility		$768.29	$5,897.00	$9,392.60
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $783.55 / $1,354.84 / $5,057.85	Professional		$783.55	$1,354.84	$5,057.85
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 $589.73 / $1,030.42 / $1,745.44	Professional		$589.73	$1,030.42	$1,745.44
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $196.80 / $415.88 / $1,228.57	Facility		$196.80	$415.88	$1,228.57
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $206.19 / $516.46 / $1,274.98	Professional		$206.19	$516.46	$1,274.98
Molina Facility/Professional Professional Modifier Low / Median / High Price $37.53 / $331.33 / $562.98	Professional		$37.53	$331.33	$562.98
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $142.30 / $161.82 / $177.88	Facility		$142.30	$161.82	$177.88
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $768.29 / $768.29 / $791.98	Facility		$768.29	$768.29	$791.98
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $883.74 / $1,259.89 / $1,572.00	Professional		$883.74	$1,259.89	$1,572.00
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $783.55 / $1,137.42 / $1,513.60	Professional		$783.55	$1,137.42	$1,513.60
United Facility/Professional Facility Modifier Low / Median / High Price $1,950.00 / $3,492.00 / $11,941.00	Facility		$1,950.00	$3,492.00	$11,941.00
United Facility/Professional Professional Modifier Low / Median / High Price $383.00 / $539.35 / $935.83	Professional		$383.00	$539.35	$935.83
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $178.15 / $178.15 / $682.23	Professional		$178.15	$178.15	$682.23