Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $239.32 / $1,253.44 / $17,100.00	Facility		$239.32	$1,253.44	$17,100.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $2,950.50 / $8,254.00 / $16,155.64	Facility	50	$2,950.50	$8,254.00	$16,155.64
Aetna Facility/Professional Professional Modifier Low / Median / High Price $239.32 / $421.68 / $949.31	Professional		$239.32	$421.68	$949.31
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $96.63 / $526.95 / $4,309.50	Professional	50	$96.63	$526.95	$4,309.50
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $1,246.32 / $9,124.02 / $17,453.22	Facility		$1,246.32	$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 $323.00 / $514.50 / $3,761.00	Professional		$323.00	$514.50	$3,761.00
Asuris Northwest Health Facility/Professional Professional Modifier 50 Low / Median / High Price $272.35 / $517.47 / $810.00	Professional	50	$272.35	$517.47	$810.00
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
Cigna Facility/Professional Professional Modifier Low / Median / High Price $287.27 / $517.74 / $901.29	Professional		$287.27	$517.74	$901.29
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $270.55 / $544.74 / $2,896.56	Facility		$270.55	$544.74	$2,896.56
Kaiser Permanente Facility/Professional Facility Modifier 50 Low / Median / High Price $6,447.65 / $8,266.54 / $19,889.25	Facility	50	$6,447.65	$8,266.54	$19,889.25
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $270.55 / $493.06 / $1,233.96	Professional		$270.55	$493.06	$1,233.96
Molina Facility/Professional Professional Modifier Low / Median / High Price $68.86 / $443.72 / $726.28	Professional		$68.86	$443.72	$726.28
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $488.42 / $592.28 / $840.18	Facility		$488.42	$592.28	$840.18
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $402.26 / $407.19 / $1,140.42	Facility		$402.26	$407.19	$1,140.42
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $318.14 / $483.48 / $759.69	Professional		$318.14	$483.48	$759.69
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 $311.14 / $471.97 / $691.86	Professional		$311.14	$471.97	$691.86
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 $363.60 / $646.46 / $864.12	Professional		$363.60	$646.46	$864.12