Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $600.30 / $621.35 / $1,407.64	Professional		$600.30	$621.35	$1,407.64
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $2,914.02 / $5,719.94	Facility		$100.00	$2,914.02	$5,719.94
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $113.88 / $906.71 / $1,408.03	Professional		$113.88	$906.71	$1,408.03
Cigna Facility/Professional Facility Modifier Low / Median / High Price $542.66 / $542.66 / $542.66	Facility		$542.66	$542.66	$542.66
Cigna Facility/Professional Professional Modifier Low / Median / High Price $396.14 / $461.26 / $1,047.23	Professional		$396.14	$461.26	$1,047.23
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,158.28 / $1,158.28 / $1,158.28	Facility		$1,158.28	$1,158.28	$1,158.28
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,158.28 / $1,158.28 / $1,158.28	Professional		$1,158.28	$1,158.28	$1,158.28
Molina Facility/Professional Professional Modifier Low / Median / High Price $115.83 / $868.71 / $1,384.79	Professional		$115.83	$868.71	$1,384.79
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,158.28 / $1,242.69 / $1,340.98	Facility		$1,158.28	$1,242.69	$1,340.98
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $105.38 / $1,053.68 / $1,053.68	Facility		$105.38	$1,053.68	$1,053.68
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $95.58 / $1,090.80 / $2,124.44	Professional		$95.58	$1,090.80	$2,124.44
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $1,124.54 / $1,124.54 / $1,124.54	Facility		$1,124.54	$1,124.54	$1,124.54
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $93.53 / $93.53 / $113.88	Professional		$93.53	$93.53	$113.88
United Facility/Professional Professional Modifier Low / Median / High Price $542.92 / $561.16 / $1,078.99	Professional		$542.92	$561.16	$1,078.99