Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,736.20 / $4,500.00 / $18,711.00	Facility		$1,736.20	$4,500.00	$18,711.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $908.20 / $1,736.20 / $3,022.28	Professional		$908.20	$1,736.20	$3,022.28
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $276.02 / $1,646.32 / $3,642.98	Facility		$276.02	$1,646.32	$3,642.98
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $1,566.60 / $2,766.47 / $9,724.43	Professional		$1,566.60	$2,766.47	$9,724.43
Cigna Facility/Professional Facility Modifier Low / Median / High Price $697.61 / $697.61 / $697.61	Facility		$697.61	$697.61	$697.61
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,157.13 / $1,847.16 / $3,534.46	Professional		$1,157.13	$1,847.16	$3,534.46
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $331.53 / $1,412.82 / $2,847.60	Facility		$331.53	$1,412.82	$2,847.60
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $331.53 / $1,462.09 / $2,862.96	Professional		$331.53	$1,462.09	$2,862.96
Molina Facility/Professional Professional Modifier Low / Median / High Price $141.32 / $772.90 / $2,258.71	Professional		$141.32	$772.90	$2,258.71
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,538.11 / $2,160.85 / $2,296.76	Facility		$1,538.11	$2,160.85	$2,296.76
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $276.02 / $1,517.10 / $1,566.60	Facility		$276.02	$1,517.10	$1,566.60
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,612.53 / $2,584.78 / $3,109.54	Professional		$1,612.53	$2,584.78	$3,109.54
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $1,195.59 / $1,646.32 / $3,151.02	Facility		$1,195.59	$1,646.32	$3,151.02
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $1,547.24 / $2,249.15 / $2,968.65	Professional		$1,547.24	$2,249.15	$2,968.65
United Facility/Professional Facility Modifier Low / Median / High Price $332.00 / $910.00 / $4,611.00	Facility		$332.00	$910.00	$4,611.00
United Facility/Professional Professional Modifier Low / Median / High Price $1,317.99 / $1,809.61 / $3,163.20	Professional		$1,317.99	$1,809.61	$3,163.20