Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $827.32 / $1,878.02 / $1,960.75	Facility		$827.32	$1,878.02	$1,960.75
Aetna Facility/Professional Professional Modifier Low / Median / High Price $602.77 / $827.32 / $1,960.75	Professional		$602.77	$827.32	$1,960.75
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $1,114.76 / $2,424.34 / $5,634.02	Facility		$1,114.76	$2,424.34	$5,634.02
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $781.39 / $1,107.58 / $6,301.80	Professional		$781.39	$1,107.58	$6,301.80
Cigna Facility/Professional Facility Modifier Low / Median / High Price $875.29 / $875.29 / $875.29	Facility		$875.29	$875.29	$875.29
Cigna Facility/Professional Professional Modifier Low / Median / High Price $638.96 / $638.96 / $875.29	Professional		$638.96	$638.96	$875.29
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $681.59 / $1,273.08 / $3,103.12	Facility		$681.59	$1,273.08	$3,103.12
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $682.33 / $1,248.55 / $2,299.62	Professional		$682.33	$1,248.55	$2,299.62
Molina Facility/Professional Professional Modifier Low / Median / High Price $878.36 / $975.96 / $1,073.55	Professional		$878.36	$975.96	$1,073.55
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,145.78 / $1,243.25 / $1,273.08	Facility		$1,145.78	$1,243.25	$1,273.08
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $1,011.36 / $1,011.36 / $1,011.36	Professional		$1,011.36	$1,011.36	$1,011.36
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,114.76 / $1,429.74 / $2,486.50	Facility		$1,114.76	$1,429.74	$2,486.50
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $1,211.74 / $1,243.25 / $1,243.25	Facility		$1,211.74	$1,243.25	$1,243.25
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $1,011.36 / $1,082.13 / $1,400.40	Professional		$1,011.36	$1,082.13	$1,400.40
United Facility/Professional Professional Modifier Low / Median / High Price $540.63 / $814.38 / $1,031.45	Professional		$540.63	$814.38	$1,031.45
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $528.73 / $528.73 / $659.00	Professional		$528.73	$528.73	$659.00