Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $933.61 / $5,377.00 / $17,100.00	Facility		$933.61	$5,377.00	$17,100.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $447.56 / $652.80 / $2,008.52	Professional		$447.56	$652.80	$2,008.52
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $3,403.52 / $5,468.48 / $11,500.00	Facility		$3,403.52	$5,468.48	$11,500.00
Asuris Northwest Health Facility/Professional Facility Modifier AS Low / Median / High Price $298.95 / $497.27 / $497.27	Facility	AS	$298.95	$497.27	$497.27
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $718.55 / $1,104.82 / $5,389.20	Professional		$718.55	$1,104.82	$5,389.20
Cigna Facility/Professional Facility Modifier Low / Median / High Price $625.25 / $761.81 / $2,190.81	Facility		$625.25	$761.81	$2,190.81
Cigna Facility/Professional Professional Modifier Low / Median / High Price $507.96 / $910.30 / $1,573.30	Professional		$507.96	$910.30	$1,573.30
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $511.56 / $1,047.15 / $1,921.26	Facility		$511.56	$1,047.15	$1,921.26
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $480.90 / $1,026.08 / $1,684.98	Professional		$480.90	$1,026.08	$1,684.98
Molina Facility/Professional Professional Modifier Low / Median / High Price $90.34 / $538.78 / $1,149.45	Professional		$90.34	$538.78	$1,149.45
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $693.32 / $958.77 / $1,036.49	Facility		$693.32	$958.77	$1,036.49
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $598.07 / $676.33 / $1,795.87	Facility		$598.07	$676.33	$1,795.87
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $774.30 / $1,124.67 / $1,403.28	Professional		$774.30	$1,124.67	$1,403.28
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $3,913.81 / $5,468.48 / $10,466.57	Facility		$3,913.81	$5,468.48	$10,466.57
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $689.77 / $1,001.92 / $1,339.70	Professional		$689.77	$1,001.92	$1,339.70
United Facility/Professional Facility Modifier Low / Median / High Price $2,408.00 / $6,984.25 / $11,261.00	Facility		$2,408.00	$6,984.25	$11,261.00
United Facility/Professional Professional Modifier Low / Median / High Price $594.91 / $827.70 / $1,455.01	Professional		$594.91	$827.70	$1,455.01
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $428.18 / $428.18 / $564.73	Professional		$428.18	$428.18	$564.73