Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $839.76 / $3,925.18 / $18,711.00	Facility		$839.76	$3,925.18	$18,711.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $367.48 / $667.74 / $1,135.78	Professional		$367.48	$667.74	$1,135.78
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $5,308.60 / $9,124.02 / $17,453.22	Facility		$5,308.60	$9,124.02	$17,453.22
Asuris Northwest Health Facility/Professional Facility Modifier 50 Low / Median / High Price $8,166.45 / $13,686.03 / $26,477.09	Facility	50	$8,166.45	$13,686.03	$26,477.09
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $653.49 / $1,178.59 / $4,073.78	Professional		$653.49	$1,178.59	$4,073.78
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,982.56 / $1,982.56 / $3,302.92	Facility		$1,982.56	$1,982.56	$3,302.92
Cigna Facility/Professional Professional Modifier Low / Median / High Price $539.74 / $970.65 / $1,460.50	Professional		$539.74	$970.65	$1,460.50
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $563.29 / $931.19 / $4,358.93	Facility		$563.29	$931.19	$4,358.93
Kaiser Permanente Facility/Professional Facility Modifier 50 Low / Median / High Price $4,358.93 / $8,266.54 / $19,889.25	Facility	50	$4,358.93	$8,266.54	$19,889.25
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $568.98 / $895.40 / $2,225.36	Professional		$568.98	$895.40	$2,225.36
Molina Facility/Professional Professional Modifier Low / Median / High Price $37.39 / $175.76 / $1,033.87	Professional		$37.39	$175.76	$1,033.87
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $593.14 / $820.75 / $945.37	Facility		$593.14	$820.75	$945.37
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $638.73 / $644.83 / $1,140.42	Facility		$638.73	$644.83	$1,140.42
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $663.73 / $1,080.48 / $1,322.53	Professional		$663.73	$1,080.48	$1,322.53
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $5,916.52 / $9,101.25 / $17,453.22	Facility		$5,916.52	$9,101.25	$17,453.22
Regence BlueShield Facility/Professional Facility Modifier 50 Low / Median / High Price $8,874.78 / $13,651.88 / $26,179.83	Facility	50	$8,874.78	$13,651.88	$26,179.83
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $651.41 / $927.59 / $1,249.44	Professional		$651.41	$927.59	$1,249.44
United Facility/Professional Facility Modifier Low / Median / High Price $1,550.00 / $2,431.00 / $11,261.00	Facility		$1,550.00	$2,431.00	$11,261.00
United Facility/Professional Professional Modifier Low / Median / High Price $557.54 / $1,001.25 / $1,371.02	Professional		$557.54	$1,001.25	$1,371.02