Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $439.09 / $1,988.79 / $17,967.00	Facility		$439.09	$1,988.79	$17,967.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $3,976.20 / $21,038.57 / $30,703.57	Facility	50	$3,976.20	$21,038.57	$30,703.57
Aetna Facility/Professional Professional Modifier Low / Median / High Price $251.03 / $397.57 / $830.82	Professional		$251.03	$397.57	$830.82
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $88.52 / $374.28 / $982.50	Professional	50	$88.52	$374.28	$982.50
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $1,694.76 / $19,395.98 / $37,102.31	Facility		$1,694.76	$19,395.98	$37,102.31
Asuris Northwest Health Facility/Professional Facility Modifier 50 Low / Median / High Price $18,840.11 / $29,093.97 / $56,285.37	Facility	50	$18,840.11	$29,093.97	$56,285.37
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $418.64 / $806.13 / $4,486.05	Professional		$418.64	$806.13	$4,486.05
Asuris Northwest Health Facility/Professional Professional Modifier 50 Low / Median / High Price $372.88 / $702.86 / $1,192.50	Professional	50	$372.88	$702.86	$1,192.50
Cigna Facility/Professional Facility Modifier Low / Median / High Price $3,448.94 / $3,448.94 / $5,745.89	Facility		$3,448.94	$3,448.94	$5,745.89
Cigna Facility/Professional Professional Modifier Low / Median / High Price $390.09 / $683.02 / $1,324.54	Professional		$390.09	$683.02	$1,324.54
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $366.22 / $629.47 / $5,947.48	Facility		$366.22	$629.47	$5,947.48
Kaiser Permanente Facility/Professional Facility Modifier 50 Low / Median / High Price $7,779.83 / $16,834.43 / $39,920.99	Facility	50	$7,779.83	$16,834.43	$39,920.99
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $366.22 / $614.82 / $1,407.18	Professional		$366.22	$614.82	$1,407.18
Molina Facility/Professional Professional Modifier Low / Median / High Price $110.25 / $706.82 / $1,152.89	Professional		$110.25	$706.82	$1,152.89
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $432.52 / $720.86 / $879.71	Facility		$432.52	$720.86	$879.71
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $597.04 / $600.04 / $2,096.73	Facility		$597.04	$600.04	$2,096.73
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $432.75 / $657.65 / $1,101.89	Professional		$432.75	$657.65	$1,101.89
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $12,577.42 / $19,384.89 / $37,102.31	Facility		$12,577.42	$19,384.89	$37,102.31
Regence BlueShield Facility/Professional Facility Modifier 50 Low / Median / High Price $18,866.13 / $29,077.34 / $55,653.47	Facility	50	$18,866.13	$29,077.34	$55,653.47
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $417.11 / $621.03 / $1,019.54	Professional		$417.11	$621.03	$1,019.54
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 $455.31 / $954.03 / $1,276.40	Professional		$455.31	$954.03	$1,276.40