Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $718.54 / $1,221.33 / $17,930.00	Facility		$718.54	$1,221.33	$17,930.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $362.97 / $621.79 / $1,297.33	Professional		$362.97	$621.79	$1,297.33
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $925.25 / $6,622.22 / $14,645.34	Facility		$925.25	$6,622.22	$14,645.34
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $640.26 / $1,082.67 / $3,498.53	Professional		$640.26	$1,082.67	$3,498.53
Cigna Facility/Professional Facility Modifier Low / Median / High Price $642.00 / $642.00 / $2,430.19	Facility		$642.00	$642.00	$2,430.19
Cigna Facility/Professional Professional Modifier Low / Median / High Price $438.97 / $724.40 / $1,407.79	Professional		$438.97	$724.40	$1,407.79
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $512.08 / $925.51 / $1,802.15	Facility		$512.08	$925.51	$1,802.15
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $512.47 / $936.60 / $1,299.14	Professional		$512.47	$936.60	$1,299.14
Molina Facility/Professional Professional Modifier Low / Median / High Price $39.24 / $274.03 / $904.16	Professional		$39.24	$274.03	$904.16
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $630.82 / $872.34 / $938.67	Facility		$630.82	$872.34	$938.67
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $616.08 / $616.08 / $666.23	Facility		$616.08	$616.08	$666.23
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $640.26 / $957.04 / $1,195.71	Professional		$640.26	$957.04	$1,195.71
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $4,294.21 / $6,618.43 / $12,667.56	Facility		$4,294.21	$6,618.43	$12,667.56
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $547.92 / $894.71 / $1,213.27	Professional		$547.92	$894.71	$1,213.27
United Facility/Professional Facility Modifier Low / Median / High Price $1,224.00 / $1,862.00 / $10,522.00	Facility		$1,224.00	$1,862.00	$10,522.00
United Facility/Professional Professional Modifier Low / Median / High Price $543.15 / $693.77 / $1,259.97	Professional		$543.15	$693.77	$1,259.97