Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $414.29 / $5,119.00 / $9,121.54	Facility		$414.29	$5,119.00	$9,121.54
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $8,216.81 / $12,933.00 / $15,088.50	Facility	50	$8,216.81	$12,933.00	$15,088.50
Aetna Facility/Professional Professional Modifier Low / Median / High Price $150.50 / $567.91 / $1,526.40	Professional		$150.50	$567.91	$1,526.40
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $625.69 / $4,318.66 / $8,788.86	Facility		$625.69	$4,318.66	$8,788.86
Asuris Northwest Health Facility/Professional Facility Modifier 50 Low / Median / High Price $5,034.33 / $6,891.83 / $13,332.98	Facility	50	$5,034.33	$6,891.83	$13,332.98
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $274.64 / $920.81 / $3,659.84	Professional		$274.64	$920.81	$3,659.84
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,007.00 / $1,007.00 / $1,677.65	Facility		$1,007.00	$1,007.00	$1,677.65
Cigna Facility/Professional Professional Modifier Low / Median / High Price $243.63 / $497.54 / $1,530.70	Professional		$243.63	$497.54	$1,530.70
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $247.43 / $860.89 / $1,756.41	Facility		$247.43	$860.89	$1,756.41
Kaiser Permanente Facility/Professional Facility Modifier 50 Low / Median / High Price $2,562.59 / $4,702.87 / $11,315.07	Facility	50	$2,562.59	$4,702.87	$11,315.07
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $243.90 / $812.70 / $1,666.79	Professional		$243.90	$812.70	$1,666.79
Molina Facility/Professional Professional Modifier Low / Median / High Price $121.77 / $773.51 / $1,271.18	Professional		$121.77	$773.51	$1,271.18
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $308.20 / $947.31 / $1,276.34	Facility		$308.20	$947.31	$1,276.34
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $625.69 / $676.36 / $703.51	Facility		$625.69	$676.36	$703.51
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $260.33 / $503.69 / $1,325.70	Professional		$260.33	$503.69	$1,325.70
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $2,979.36 / $4,591.92 / $8,788.86	Facility		$2,979.36	$4,591.92	$8,788.86
Regence BlueShield Facility/Professional Facility Modifier 50 Low / Median / High Price $4,469.04 / $6,887.88 / $13,183.29	Facility	50	$4,469.04	$6,887.88	$13,183.29
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $243.94 / $609.87 / $1,149.22	Professional		$243.94	$609.87	$1,149.22
United Facility/Professional Facility Modifier Low / Median / High Price $879.00 / $1,689.00 / $7,385.00	Facility		$879.00	$1,689.00	$7,385.00
United Facility/Professional Professional Modifier Low / Median / High Price $755.04 / $1,096.79 / $1,647.37	Professional		$755.04	$1,096.79	$1,647.37