Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $701.28 / $701.65 / $1,105.92	Professional		$701.28	$701.65	$1,105.92
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $1,169.67 / $7,407.45 / $7,407.45	Facility		$1,169.67	$7,407.45	$7,407.45
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $779.08 / $1,033.06 / $1,403.30	Professional		$779.08	$1,033.06	$1,403.30
Cigna Facility/Professional Facility Modifier Low / Median / High Price $606.51 / $606.51 / $606.51	Facility		$606.51	$606.51	$606.51
Cigna Facility/Professional Professional Modifier Low / Median / High Price $122.23 / $515.53 / $799.20	Professional		$122.23	$515.53	$799.20
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,403.30 / $1,403.30 / $1,403.30	Facility		$1,403.30	$1,403.30	$1,403.30
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,403.30 / $1,403.30 / $1,403.30	Professional		$1,403.30	$1,403.30	$1,403.30
Molina Facility/Professional Professional Modifier Low / Median / High Price $968.20 / $1,233.35 / $1,543.63	Professional		$968.20	$1,233.35	$1,543.63
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,186.68 / $2,545.98 / $2,803.95	Facility		$1,186.68	$2,545.98	$2,803.95
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $2,301.75 / $2,545.98 / $2,803.95	Professional		$2,301.75	$2,545.98	$2,803.95
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,164.83 / $1,164.83 / $2,471.05	Professional		$1,164.83	$1,164.83	$2,471.05
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $94.76 / $94.76 / $115.38	Professional		$94.76	$94.76	$115.38
United Facility/Professional Professional Modifier Low / Median / High Price $638.34 / $697.80 / $1,221.15	Professional		$638.34	$697.80	$1,221.15
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,000.26 / $1,000.26 / $1,000.26	Professional		$1,000.26	$1,000.26	$1,000.26