Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $727.00 / $1,650.29 / $1,722.99	Facility		$727.00	$1,650.29	$1,722.99
Aetna Facility/Professional Professional Modifier Low / Median / High Price $546.29 / $727.00 / $1,650.29	Professional		$546.29	$727.00	$1,650.29
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $943.30 / $1,841.05 / $5,140.93	Facility		$943.30	$1,841.05	$5,140.93
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $786.41 / $943.30 / $5,568.19	Professional		$786.41	$943.30	$5,568.19
Cigna Facility/Professional Facility Modifier Low / Median / High Price $616.27 / $616.27 / $616.27	Facility		$616.27	$616.27	$616.27
Cigna Facility/Professional Professional Modifier Low / Median / High Price $449.88 / $449.88 / $616.27	Professional		$449.88	$449.88	$616.27
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $783.99 / $1,238.86 / $3,123.67	Facility		$783.99	$1,238.86	$3,123.67
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $783.99 / $1,225.14 / $2,125.16	Professional		$783.99	$1,225.14	$2,125.16
Molina Facility/Professional Professional Modifier Low / Median / High Price $743.26 / $825.85 / $908.43	Professional		$743.26	$825.85	$908.43
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,052.03 / $1,077.28 / $1,185.01	Facility		$1,052.03	$1,077.28	$1,185.01
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $855.80 / $855.80 / $855.80	Professional		$855.80	$855.80	$855.80
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $894.23 / $943.30 / $2,051.46	Facility		$894.23	$943.30	$2,051.46
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $894.23 / $974.10 / $1,209.83	Professional		$894.23	$974.10	$1,209.83
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $1,025.36 / $1,052.03 / $1,052.03	Facility		$1,025.36	$1,052.03	$1,052.03
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $855.80 / $915.69 / $1,185.01	Professional		$855.80	$915.69	$1,185.01
United Facility/Professional Professional Modifier Low / Median / High Price $470.09 / $509.26 / $938.72	Professional		$470.09	$509.26	$938.72
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $659.29 / $915.69 / $915.69	Professional		$659.29	$915.69	$915.69