Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,744.61 / $6,950.88 / $27,982.24	Facility		$1,744.61	$6,950.88	$27,982.24
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,090.97 / $1,634.68 / $2,973.33	Professional		$1,090.97	$1,634.68	$2,973.33
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $16,357.99 / $49,664.15 / $95,056.24	Facility		$16,357.99	$49,664.15	$95,056.24
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $1,795.79 / $2,968.73 / $25,915.00	Professional		$1,795.79	$2,968.73	$25,915.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $17,132.00 / $17,691.00 / $36,898.00	Facility		$17,132.00	$17,691.00	$36,898.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,754.01 / $2,625.06 / $3,834.58	Professional		$1,754.01	$2,625.06	$3,834.58
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,623.75 / $2,893.39 / $56,216.48	Facility		$1,623.75	$2,893.39	$56,216.48
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,623.75 / $2,830.37 / $3,489.85	Professional		$1,623.75	$2,830.37	$3,489.85
Molina Facility/Professional Professional Modifier Low / Median / High Price $323.41 / $2,007.26 / $3,248.33	Professional		$323.41	$2,007.26	$3,248.33
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,981.71 / $2,456.50 / $2,643.16	Facility		$1,981.71	$2,456.50	$2,643.16
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,760.81 / $1,760.81 / $1,768.59	Facility		$1,760.81	$1,760.81	$1,768.59
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,832.06 / $2,934.03 / $3,511.66	Professional		$1,832.06	$2,934.03	$3,511.66
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $34,852.28 / $49,692.55 / $95,056.24	Facility		$34,852.28	$49,692.55	$95,056.24
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $1,795.79 / $2,544.14 / $3,426.89	Professional		$1,795.79	$2,544.14	$3,426.89
United Facility/Professional Facility Modifier Low / Median / High Price $3,960.00 / $16,613.00 / $43,830.00	Facility		$3,960.00	$16,613.00	$43,830.00
United Facility/Professional Professional Modifier Low / Median / High Price $1,666.27 / $2,388.86 / $3,756.67	Professional		$1,666.27	$2,388.86	$3,756.67