Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $288.85 / $4,209.68 / $18,711.00	Facility		$288.85	$4,209.68	$18,711.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $10,218.26 / $10,218.26 / $10,218.26	Facility	50	$10,218.26	$10,218.26	$10,218.26
Aetna Facility/Professional Professional Modifier Low / Median / High Price $158.83 / $1,694.95 / $3,371.40	Professional		$158.83	$1,694.95	$3,371.40
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $126.09 / $1,552.85 / $2,885.34	Professional	50	$126.09	$1,552.85	$2,885.34
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $2,252.55 / $18,231.29 / $37,102.31	Facility		$2,252.55	$18,231.29	$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 $285.57 / $3,123.73 / $12,112.80	Professional		$285.57	$3,123.73	$12,112.80
Asuris Northwest Health Facility/Professional Professional Modifier 50 Low / Median / High Price $242.03 / $2,745.33 / $4,479.00	Professional	50	$242.03	$2,745.33	$4,479.00
Asuris Northwest Health Facility/Professional Professional Modifier 80 Low / Median / High Price $48.77 / $476.71 / $476.71	Professional	80	$48.77	$476.71	$476.71
Asuris Northwest Health Facility/Professional Professional Modifier AS Low / Median / High Price $41.45 / $405.20 / $405.20	Professional	AS	$41.45	$405.20	$405.20
Cigna Facility/Professional Facility Modifier Low / Median / High Price $4,371.41 / $4,371.41 / $7,282.72	Facility		$4,371.41	$4,371.41	$7,282.72
Cigna Facility/Professional Professional Modifier Low / Median / High Price $253.64 / $558.29 / $5,078.37	Professional		$253.64	$558.29	$5,078.37
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $245.25 / $3,057.27 / $5,947.48	Facility		$245.25	$3,057.27	$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 $243.39 / $2,445.81 / $5,515.92	Professional		$243.39	$2,445.81	$5,515.92
Molina Facility/Professional Professional Modifier Low / Median / High Price $413.35 / $2,595.61 / $4,287.60	Professional		$413.35	$2,595.61	$4,287.60
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $368.52 / $3,101.79 / $3,935.58	Facility		$368.52	$3,101.79	$3,935.58
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,736.33 / $2,252.55 / $2,348.81	Facility		$1,736.33	$2,252.55	$2,348.81
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $270.68 / $523.70 / $4,394.35	Professional		$270.68	$523.70	$4,394.35
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 $274.95 / $1,856.14 / $3,815.05	Professional		$274.95	$1,856.14	$3,815.05
United Facility/Professional Facility Modifier Low / Median / High Price $2,155.00 / $3,297.00 / $12,835.00	Facility		$2,155.00	$3,297.00	$12,835.00
United Facility/Professional Professional Modifier Low / Median / High Price $2,355.77 / $3,587.18 / $5,152.64	Professional		$2,355.77	$3,587.18	$5,152.64