Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,214.63 / $1,943.40 / $2,577.92	Facility		$1,214.63	$1,943.40	$2,577.92
Aetna Facility/Professional Professional Modifier Low / Median / High Price $960.00 / $1,214.63 / $2,068.51	Professional		$960.00	$1,214.63	$2,068.51
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $1,209.77 / $2,425.31 / $5,203.28	Facility		$1,209.77	$2,425.31	$5,203.28
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $1,166.05 / $1,238.93 / $1,457.56	Professional		$1,166.05	$1,238.93	$1,457.56
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,238.93 / $1,238.93 / $3,632.44	Facility		$1,238.93	$1,238.93	$3,632.44
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,238.93 / $1,238.93 / $1,238.93	Professional		$1,238.93	$1,238.93	$1,238.93
Molina Facility/Professional Professional Modifier Low / Median / High Price $1,040.65 / $1,214.63 / $2,429.26	Professional		$1,040.65	$1,214.63	$2,429.26
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $79,999.20 / $79,999.20 / $79,999.20	Facility		$79,999.20	$79,999.20	$79,999.20
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,209.77 / $2,294.21 / $3,605.20	Facility		$1,209.77	$2,294.21	$3,605.20
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,122.32 / $1,238.93 / $1,457.56	Professional		$1,122.32	$1,238.93	$1,457.56
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $1,238.93 / $1,238.93 / $1,238.93	Facility		$1,238.93	$1,238.93	$1,238.93
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $1,238.93 / $1,238.93 / $1,238.93	Professional		$1,238.93	$1,238.93	$1,238.93
United Facility/Professional Professional Modifier Low / Median / High Price $485.85 / $1,214.63 / $1,214.63	Professional		$485.85	$1,214.63	$1,214.63
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,214.63 / $1,214.63 / $1,214.63	Professional		$1,214.63	$1,214.63	$1,214.63