Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $212.77 / $2,950.50 / $17,100.00	Facility		$212.77	$2,950.50	$17,100.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $693.17 / $2,865.00 / $10,754.00	Facility	50	$693.17	$2,865.00	$10,754.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $137.16 / $212.77 / $413.70	Professional		$137.16	$212.77	$413.70
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $38.67 / $115.91 / $636.23	Professional	50	$38.67	$115.91	$636.23
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $3,032.15 / $5,113.79 / $12,444.54	Facility		$3,032.15	$5,113.79	$12,444.54
Asuris Northwest Health Facility/Professional Facility Modifier 50 Low / Median / High Price $5,510.97 / $7,492.77 / $13,957.79	Facility	50	$5,510.97	$7,492.77	$13,957.79
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $223.91 / $372.58 / $2,496.46	Professional		$223.91	$372.58	$2,496.46
Asuris Northwest Health Facility/Professional Professional Modifier 50 Low / Median / High Price $242.55 / $461.06 / $519.00	Professional	50	$242.55	$461.06	$519.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,126.23 / $1,126.23 / $1,876.28	Facility		$1,126.23	$1,126.23	$1,876.28
Cigna Facility/Professional Professional Modifier Low / Median / High Price $201.46 / $328.04 / $480.42	Professional		$201.46	$328.04	$480.42
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $197.40 / $362.07 / $4,829.01	Facility		$197.40	$362.07	$4,829.01
Kaiser Permanente Facility/Professional Facility Modifier 50 Low / Median / High Price $4,829.01 / $5,516.87 / $11,618.58	Facility	50	$4,829.01	$5,516.87	$11,618.58
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $205.11 / $343.23 / $1,264.15	Professional		$205.11	$343.23	$1,264.15
Molina Facility/Professional Professional Modifier Low / Median / High Price $42.93 / $275.27 / $450.34	Professional		$42.93	$275.27	$450.34
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $230.84 / $305.52 / $318.92	Facility		$230.84	$305.52	$318.92
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $210.65 / $217.53 / $676.20	Facility		$210.65	$217.53	$676.20
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $228.41 / $360.27 / $446.15	Professional		$228.41	$360.27	$446.15
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $3,673.98 / $4,809.85 / $9,200.71	Facility		$3,673.98	$4,809.85	$9,200.71
Regence BlueShield Facility/Professional Facility Modifier 50 Low / Median / High Price $5,510.97 / $7,214.79 / $13,801.08	Facility	50	$5,510.97	$7,214.79	$13,801.08
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $214.83 / $312.92 / $421.50	Professional		$214.83	$312.92	$421.50
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 $202.00 / $341.65 / $456.69	Professional		$202.00	$341.65	$456.69