Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $895.08 / $1,053.06 / $1,411.11	Professional		$895.08	$1,053.06	$1,411.11
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $184.46 / $9,451.79 / $9,451.79	Facility		$184.46	$9,451.79	$9,451.79
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $1,143.60 / $1,165.68 / $2,211.92	Professional		$1,143.60	$1,165.68	$2,211.92
Cigna Facility/Professional Facility Modifier Low / Median / High Price $396.70 / $396.70 / $396.70	Facility		$396.70	$396.70	$396.70
Cigna Facility/Professional Professional Modifier Low / Median / High Price $156.33 / $337.20 / $396.70	Professional		$156.33	$337.20	$396.70
Molina Facility/Professional Professional Modifier Low / Median / High Price $60.00 / $210.66 / $210.66	Professional		$60.00	$210.66	$210.66
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $2,937.00 / $3,527.71 / $3,577.80	Facility		$2,937.00	$3,527.71	$3,577.80
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $2,937.00 / $3,527.71 / $3,577.80	Professional		$2,937.00	$3,527.71	$3,577.80
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $184.46 / $184.46 / $184.46	Facility		$184.46	$184.46	$184.46
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $370.94 / $1,881.49 / $3,709.44	Professional		$370.94	$1,881.49	$3,709.44
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $142.25 / $142.25 / $173.20	Professional		$142.25	$142.25	$173.20
United Facility/Professional Professional Modifier Low / Median / High Price $709.07 / $886.51 / $1,477.51	Professional		$709.07	$886.51	$1,477.51
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,095.21 / $1,095.21 / $1,095.21	Professional		$1,095.21	$1,095.21	$1,095.21