Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $928.16 / $2,106.92 / $2,199.73	Facility		$928.16	$2,106.92	$2,199.73
Aetna Facility/Professional Professional Modifier Low / Median / High Price $682.53 / $928.16 / $2,199.73	Professional		$682.53	$928.16	$2,199.73
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $1,204.32 / $2,864.98 / $5,601.21	Facility		$1,204.32	$2,864.98	$5,601.21
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $808.16 / $1,169.07 / $9,057.24	Professional		$808.16	$1,169.07	$9,057.24
Cigna Facility/Professional Facility Modifier Low / Median / High Price $740.83 / $740.83 / $740.83	Facility		$740.83	$740.83	$740.83
Cigna Facility/Professional Professional Modifier Low / Median / High Price $540.80 / $540.80 / $740.83	Professional		$540.80	$540.80	$740.83
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $655.20 / $1,306.60 / $2,983.12	Facility		$655.20	$1,306.60	$2,983.12
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $655.92 / $1,306.60 / $2,210.25	Professional		$655.92	$1,306.60	$2,210.25
Molina Facility/Professional Professional Modifier Low / Median / High Price $948.93 / $1,054.36 / $1,159.80	Professional		$948.93	$1,054.36	$1,159.80
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,091.73 / $1,237.83 / $1,375.38	Facility		$1,091.73	$1,237.83	$1,375.38
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $1,091.73 / $1,306.60 / $1,375.38	Professional		$1,091.73	$1,306.60	$1,375.38
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,204.32 / $1,544.61 / $2,686.28	Facility		$1,204.32	$1,544.61	$2,686.28
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $1,309.09 / $1,343.14 / $1,343.14	Facility		$1,309.09	$1,343.14	$1,343.14
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $1,092.60 / $1,169.07 / $1,512.92	Professional		$1,092.60	$1,169.07	$1,512.92
United Facility/Professional Professional Modifier Low / Median / High Price $480.48 / $524.48 / $991.48	Professional		$480.48	$524.48	$991.48
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $255.00 / $255.00 / $628.75	Professional		$255.00	$255.00	$628.75