Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $690.30 / $690.30 / $690.30	Facility		$690.30	$690.30	$690.30
Aetna Facility/Professional Professional Modifier Low / Median / High Price $546.34 / $772.70 / $1,114.07	Professional		$546.34	$772.70	$1,114.07
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $76.00 / $1,867.38 / $5,143.63	Facility		$76.00	$1,867.38	$5,143.63
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $205.74 / $1,978.41 / $8,459.33	Professional		$205.74	$1,978.41	$8,459.33
Cigna Facility/Professional Facility Modifier Low / Median / High Price $845.38 / $845.38 / $845.38	Facility		$845.38	$845.38	$845.38
Cigna Facility/Professional Professional Modifier Low / Median / High Price $718.57 / $718.57 / $845.38	Professional		$718.57	$718.57	$845.38
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,495.89 / $1,816.22 / $2,789.30	Facility		$1,495.89	$1,816.22	$2,789.30
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $861.27 / $1,754.77 / $3,186.41	Professional		$861.27	$1,754.77	$3,186.41
Molina Facility/Professional Professional Modifier Low / Median / High Price $60.00 / $98.01 / $98.01	Professional		$60.00	$98.01	$98.01
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,598.30 / $1,919.76 / $1,947.02	Facility		$1,598.30	$1,919.76	$1,947.02
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $1,598.30 / $1,919.76 / $1,947.02	Professional		$1,598.30	$1,919.76	$1,947.02
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $121.09 / $121.09 / $121.09	Facility		$121.09	$121.09	$121.09
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $80.88 / $80.88 / $1,235.11	Professional		$80.88	$80.88	$1,235.11
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $168.97 / $168.97 / $205.74	Professional		$168.97	$168.97	$205.74
United Facility/Professional Professional Modifier Low / Median / High Price $65.62 / $109.37 / $386.93	Professional		$65.62	$109.37	$386.93
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $806.67 / $806.67 / $806.67	Professional		$806.67	$806.67	$806.67