Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $762.88 / $762.88 / $762.88	Facility		$762.88	$762.88	$762.88
Aetna Facility/Professional Professional Modifier Low / Median / High Price $718.00 / $762.88 / $762.88	Professional		$718.00	$762.88	$762.88
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $318.02 / $744.92 / $3,365.63	Facility		$318.02	$744.92	$3,365.63
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $762.88 / $3,410.50 / $4,038.75	Professional		$762.88	$3,410.50	$4,038.75
Cigna Facility/Professional Facility Modifier Low / Median / High Price $762.88 / $762.88 / $3,018.88	Facility		$762.88	$762.88	$3,018.88
Cigna Facility/Professional Professional Modifier Low / Median / High Price $762.88 / $762.88 / $762.88	Professional		$762.88	$762.88	$762.88
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $528.38 / $1,224.35 / $1,865.77	Facility		$528.38	$1,224.35	$1,865.77
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $528.38 / $1,320.66 / $1,892.77	Professional		$528.38	$1,320.66	$1,892.77
Molina Facility/Professional Professional Modifier Low / Median / High Price $30.00 / $75.00 / $919.55	Professional		$30.00	$75.00	$919.55
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $919.55 / $919.55 / $79,999.20	Facility		$919.55	$919.55	$79,999.20
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $308.95 / $412.75 / $762.88	Facility		$308.95	$412.75	$762.88
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $691.08 / $762.88 / $807.75	Professional		$691.08	$762.88	$807.75
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $350.58 / $350.58 / $385.64	Facility		$350.58	$350.58	$385.64
United Facility/Professional Professional Modifier Low / Median / High Price $1,997.50 / $1,997.50 / $2,397.00	Professional		$1,997.50	$1,997.50	$2,397.00
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $718.00 / $718.00 / $718.00	Professional		$718.00	$718.00	$718.00