Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $798.26 / $1,812.05 / $1,891.88	Facility		$798.26	$1,812.05	$1,891.88
Aetna Facility/Professional Professional Modifier Low / Median / High Price $659.80 / $798.26 / $1,891.88	Professional		$659.80	$798.26	$1,891.88
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $1,035.77 / $3,152.76 / $6,310.18	Facility		$1,035.77	$3,152.76	$6,310.18
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $863.50 / $1,150.59 / $9,966.95	Professional		$863.50	$1,150.59	$9,966.95
Cigna Facility/Professional Facility Modifier Low / Median / High Price $736.22 / $736.22 / $736.22	Facility		$736.22	$736.22	$736.22
Cigna Facility/Professional Professional Modifier Low / Median / High Price $537.44 / $537.44 / $745.79	Professional		$537.44	$537.44	$745.79
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $741.19 / $1,253.01 / $3,241.38	Facility		$741.19	$1,253.01	$3,241.38
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $742.00 / $1,262.32 / $2,499.87	Professional		$742.00	$1,262.32	$2,499.87
Molina Facility/Professional Professional Modifier Low / Median / High Price $90.68 / $816.12 / $997.48	Professional		$90.68	$816.12	$997.48
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $938.94 / $1,155.15 / $1,182.86	Facility		$938.94	$1,155.15	$1,182.86
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $1,123.73 / $1,182.86 / $1,182.86	Professional		$1,123.73	$1,182.86	$1,182.86
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,035.77 / $1,328.42 / $2,310.30	Facility		$1,035.77	$1,328.42	$2,310.30
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $1,125.88 / $1,155.15 / $1,155.15	Facility		$1,125.88	$1,155.15	$1,155.15
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $939.69 / $1,005.44 / $1,301.16	Professional		$939.69	$1,005.44	$1,301.16
United Facility/Professional Professional Modifier Low / Median / High Price $543.47 / $634.04 / $1,121.44	Professional		$543.47	$634.04	$1,121.44
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $475.65 / $475.65 / $1,005.44	Professional		$475.65	$475.65	$1,005.44