Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $602.36 / $2,550.00 / $18,711.00	Facility		$602.36	$2,550.00	$18,711.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $5,650.67 / $12,929.38 / $18,315.00	Facility	50	$5,650.67	$12,929.38	$18,315.00
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $321.39 / $1,007.78 / $5,698.36	Professional	50	$321.39	$1,007.78	$5,698.36
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $5,308.60 / $9,124.02 / $23,606.56	Facility		$5,308.60	$9,124.02	$23,606.56
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 50 Low / Median / High Price $586.17 / $1,197.17 / $1,374.00	Professional	50	$586.17	$1,197.17	$1,374.00
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
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $495.95 / $819.63 / $4,358.93	Facility		$495.95	$819.63	$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
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $532.44 / $723.60 / $844.20	Facility		$532.44	$723.60	$844.20
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $571.23 / $575.82 / $1,140.42	Facility		$571.23	$575.82	$1,140.42
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
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