Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,289.93 / $5,128.00 / $21,917.86	Facility		$1,289.93	$5,128.00	$21,917.86
Aetna Facility/Professional Professional Modifier Low / Median / High Price $648.07 / $888.98 / $1,969.40	Professional		$648.07	$888.98	$1,969.40
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $3,018.30 / $9,172.83 / $20,286.13	Facility		$3,018.30	$9,172.83	$20,286.13
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $999.13 / $1,608.32 / $6,182.55	Professional		$999.13	$1,608.32	$6,182.55
Cigna Facility/Professional Facility Modifier Low / Median / High Price $883.20 / $1,075.31 / $3,740.43	Facility		$883.20	$1,075.31	$3,740.43
Cigna Facility/Professional Professional Modifier Low / Median / High Price $732.70 / $1,257.72 / $2,146.06	Professional		$732.70	$1,257.72	$2,146.06
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $730.80 / $1,485.80 / $3,280.24	Facility		$730.80	$1,485.80	$3,280.24
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $668.85 / $1,440.57 / $2,824.57	Professional		$668.85	$1,440.57	$2,824.57
Molina Facility/Professional Professional Modifier Low / Median / High Price $93.33 / $724.31 / $1,567.38	Professional		$93.33	$724.31	$1,567.38
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $986.37 / $1,335.98 / $1,423.08	Facility		$986.37	$1,335.98	$1,423.08
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $928.20 / $970.67 / $2,961.46	Facility		$928.20	$970.67	$2,961.46
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,073.33 / $1,544.15 / $1,926.68	Professional		$1,073.33	$1,544.15	$1,926.68
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $6,013.44 / $9,167.59 / $17,546.59	Facility		$6,013.44	$9,167.59	$17,546.59
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $946.64 / $1,381.62 / $1,839.38	Professional		$946.64	$1,381.62	$1,839.38
United Facility/Professional Facility Modifier Low / Median / High Price $2,155.00 / $3,129.00 / $11,941.00	Facility		$2,155.00	$3,129.00	$11,941.00
United Facility/Professional Professional Modifier Low / Median / High Price $842.10 / $1,147.81 / $2,016.92	Professional		$842.10	$1,147.81	$2,016.92
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $591.89 / $591.89 / $769.99	Professional		$591.89	$591.89	$769.99