Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $673.43 / $1,151.24 / $17,930.00	Facility		$673.43	$1,151.24	$17,930.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $343.68 / $589.05 / $1,213.18	Professional		$343.68	$589.05	$1,213.18
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $940.61 / $6,622.22 / $14,645.34	Facility		$940.61	$6,622.22	$14,645.34
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $591.82 / $941.26 / $3,680.00	Professional		$591.82	$941.26	$3,680.00
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 $433.96 / $690.38 / $1,326.63	Professional		$433.96	$690.38	$1,326.63
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $472.03 / $860.96 / $1,802.15	Facility		$472.03	$860.96	$1,802.15
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $477.24 / $873.49 / $1,278.83	Professional		$477.24	$873.49	$1,278.83
Molina Facility/Professional Professional Modifier Low / Median / High Price $69.86 / $268.21 / $846.66	Professional		$69.86	$268.21	$846.66
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $598.00 / $825.44 / $879.71	Facility		$598.00	$825.44	$879.71
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $580.29 / $580.29 / $925.25	Facility		$580.29	$580.29	$925.25
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $600.04 / $905.86 / $1,123.89	Professional		$600.04	$905.86	$1,123.89
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $4,832.13 / $6,618.43 / $12,667.56	Facility		$4,832.13	$6,618.43	$12,667.56
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $523.45 / $833.04 / $1,137.06	Professional		$523.45	$833.04	$1,137.06
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 $513.57 / $659.86 / $1,195.21	Professional		$513.57	$659.86	$1,195.21