Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $556.54 / $1,105.15 / $1,867.47	Facility		$556.54	$1,105.15	$1,867.47
Aetna Facility/Professional Professional Modifier Low / Median / High Price $459.05 / $571.50 / $1,234.88	Professional		$459.05	$571.50	$1,234.88
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $1,085.85 / $1,732.47 / $5,563.56	Facility		$1,085.85	$1,732.47	$5,563.56
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $735.50 / $1,291.83 / $4,733.18	Professional		$735.50	$1,291.83	$4,733.18
Cigna Facility/Professional Facility Modifier Low / Median / High Price $583.05 / $1,511.72 / $2,276.14	Facility		$583.05	$1,511.72	$2,276.14
Cigna Facility/Professional Professional Modifier Low / Median / High Price $667.79 / $1,090.29 / $1,758.26	Professional		$667.79	$1,090.29	$1,758.26
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $506.23 / $1,026.28 / $1,753.12	Facility		$506.23	$1,026.28	$1,753.12
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $520.03 / $1,054.89 / $1,464.31	Professional		$520.03	$1,054.89	$1,464.31
Molina Facility/Professional Professional Modifier Low / Median / High Price $87.45 / $522.59 / $1,158.72	Professional		$87.45	$522.59	$1,158.72
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $717.54 / $1,005.00 / $1,113.54	Facility		$717.54	$1,005.00	$1,113.54
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $721.18 / $721.18 / $759.53	Facility		$721.18	$721.18	$759.53
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $842.47 / $1,266.94 / $1,507.60	Professional		$842.47	$1,266.94	$1,507.60
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $1,081.75 / $1,627.87 / $3,172.39	Facility		$1,081.75	$1,627.87	$3,172.39
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $735.50 / $1,133.50 / $1,492.81	Professional		$735.50	$1,133.50	$1,492.81
United Facility/Professional Professional Modifier Low / Median / High Price $585.59 / $683.90 / $1,420.57	Professional		$585.59	$683.90	$1,420.57
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $628.29 / $628.29 / $628.29	Professional		$628.29	$628.29	$628.29