Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,733.00 / $5,128.00 / $24,827.00	Facility		$1,733.00	$5,128.00	$24,827.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,113.79 / $1,677.08 / $3,182.98	Professional		$1,113.79	$1,677.08	$3,182.98
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $9,866.94 / $16,595.73 / $31,745.76	Facility		$9,866.94	$16,595.73	$31,745.76
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $1,740.01 / $3,086.77 / $10,669.35	Professional		$1,740.01	$3,086.77	$10,669.35
Cigna Facility/Professional Facility Modifier Low / Median / High Price $4,147.74 / $4,147.74 / $6,910.09	Facility		$4,147.74	$4,147.74	$6,910.09
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,465.16 / $2,609.83 / $3,824.84	Professional		$1,465.16	$2,609.83	$3,824.84
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,570.80 / $2,650.05 / $11,234.92	Facility		$1,570.80	$2,650.05	$11,234.92
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,578.10 / $2,513.04 / $4,655.70	Professional		$1,578.10	$2,513.04	$4,655.70
Molina Facility/Professional Professional Modifier Low / Median / High Price $112.66 / $439.76 / $2,699.91	Professional		$112.66	$439.76	$2,699.91
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,701.34 / $2,304.13 / $2,481.32	Facility		$1,701.34	$2,304.13	$2,481.32
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,676.55 / $1,690.44 / $2,513.62	Facility		$1,676.55	$1,690.44	$2,513.62
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,752.83 / $2,829.79 / $3,467.07	Professional		$1,752.83	$2,829.79	$3,467.07
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $10,761.59 / $16,586.25 / $31,745.76	Facility		$10,761.59	$16,586.25	$31,745.76
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $1,709.86 / $2,431.71 / $3,275.46	Professional		$1,709.86	$2,431.71	$3,275.46
United Facility/Professional Facility Modifier Low / Median / High Price $2,912.00 / $3,509.00 / $17,644.00	Facility		$2,912.00	$3,509.00	$17,644.00
United Facility/Professional Professional Modifier Low / Median / High Price $1,505.69 / $2,292.75 / $3,590.68	Professional		$1,505.69	$2,292.75	$3,590.68