Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $360.25 / $7,394.00 / $31,444.65	Facility		$360.25	$7,394.00	$31,444.65
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $3,107.15 / $8,096.76 / $36,045.57	Facility	50	$3,107.15	$8,096.76	$36,045.57
Aetna Facility/Professional Professional Modifier Low / Median / High Price $267.70 / $353.19 / $815.33	Professional		$267.70	$353.19	$815.33
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $197.78 / $289.56 / $1,112.36	Professional	50	$197.78	$289.56	$1,112.36
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $11,296.15 / $19,395.98 / $37,102.31	Facility		$11,296.15	$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 $372.56 / $614.99 / $5,305.00	Professional		$372.56	$614.99	$5,305.00
Asuris Northwest Health Facility/Professional Professional Modifier 50 Low / Median / High Price $406.92 / $765.62 / $892.50	Professional	50	$406.92	$765.62	$892.50
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 $337.71 / $549.10 / $796.86	Professional		$337.71	$549.10	$796.86
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $379.00 / $642.78 / $7,779.83	Facility		$379.00	$642.78	$7,779.83
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 $382.53 / $595.72 / $3,871.31	Professional		$382.53	$595.72	$3,871.31
Molina Facility/Professional Professional Modifier Low / Median / High Price $75.67 / $482.19 / $791.01	Professional		$75.67	$482.19	$791.01
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $435.34 / $514.20 / $611.04	Facility		$435.34	$514.20	$611.04
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $352.89 / $361.94 / $2,096.73	Facility		$352.89	$361.94	$2,096.73
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $385.03 / $602.79 / $742.34	Professional		$385.03	$602.79	$742.34
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 $359.90 / $520.66 / $701.32	Professional		$359.90	$520.66	$701.32
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 $319.62 / $516.24 / $761.78	Professional		$319.62	$516.24	$761.78