Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,059.51 / $17,760.00 / $64,920.00	Facility		$2,059.51	$17,760.00	$64,920.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $950.00 / $1,900.00 / $11,280.00	Professional		$950.00	$1,900.00	$11,280.00
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $12,600.00 / $19,692.00 / $57,000.00	Facility		$12,600.00	$19,692.00	$57,000.00
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $3,196.91 / $12,000.00 / $60,000.00	Professional		$3,196.91	$12,000.00	$60,000.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,218.00 / $12,480.00 / $30,275.70	Facility		$1,218.00	$12,480.00	$30,275.70
Cigna Facility/Professional Professional Modifier Low / Median / High Price $7,441.51 / $13,789.24 / $17,236.56	Professional		$7,441.51	$13,789.24	$17,236.56
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $11,842.31 / $15,000.00 / $34,254.83	Facility		$11,842.31	$15,000.00	$34,254.83
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $12,000.00 / $17,640.00 / $33,207.98	Professional		$12,000.00	$17,640.00	$33,207.98
Molina Facility/Professional Professional Modifier Low / Median / High Price $766.84 / $1,054.41 / $1,380.00	Professional		$766.84	$1,054.41	$1,380.00
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $12,000.00 / $12,000.00 / $25,200.00	Facility		$12,000.00	$12,000.00	$25,200.00
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,380.00 / $18,000.00 / $33,000.00	Facility		$1,380.00	$18,000.00	$33,000.00
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $10,800.00 / $14,400.00 / $17,040.00	Professional		$10,800.00	$14,400.00	$17,040.00
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $12,600.00 / $19,692.00 / $33,000.00	Facility		$12,600.00	$19,692.00	$33,000.00
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $10,863.43 / $21,107.28 / $29,391.96	Professional		$10,863.43	$21,107.28	$29,391.96
United Facility/Professional Professional Modifier Low / Median / High Price $5,040.00 / $5,040.00 / $13,440.00	Professional		$5,040.00	$5,040.00	$13,440.00
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $5,400.00 / $5,400.00 / $6,216.00	Professional		$5,400.00	$5,400.00	$6,216.00