Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $330.35 / $4,267.58 / $18,711.00	Facility		$330.35	$4,267.58	$18,711.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $17,318.59 / $17,318.59 / $17,318.59	Facility	50	$17,318.59	$17,318.59	$17,318.59
Aetna Facility/Professional Professional Modifier Low / Median / High Price $189.24 / $1,036.33 / $4,803.38	Professional		$189.24	$1,036.33	$4,803.38
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $397.92 / $397.92 / $397.92	Professional	50	$397.92	$397.92	$397.92
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $2,286.83 / $18,231.29 / $37,102.31	Facility		$2,286.83	$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 $324.37 / $3,033.93 / $11,062.39	Professional		$324.37	$3,033.93	$11,062.39
Asuris Northwest Health Facility/Professional Professional Modifier 50 Low / Median / High Price $275.00 / $520.83 / $4,548.00	Professional	50	$275.00	$520.83	$4,548.00
Asuris Northwest Health Facility/Professional Professional Modifier AS Low / Median / High Price $47.22 / $412.00 / $412.00	Professional	AS	$47.22	$412.00	$412.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,035.92 / $2,035.92 / $3,391.81	Facility		$2,035.92	$2,035.92	$3,391.81
Cigna Facility/Professional Professional Modifier Low / Median / High Price $288.08 / $593.09 / $5,216.06	Professional		$288.08	$593.09	$5,216.06
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $279.58 / $2,476.37 / $8,870.45	Facility		$279.58	$2,476.37	$8,870.45
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 $277.51 / $2,144.26 / $5,603.77	Professional		$277.51	$2,144.26	$5,603.77
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 $376.54 / $3,152.51 / $4,121.43	Facility		$376.54	$3,152.51	$4,121.43
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,747.02 / $2,286.83 / $2,381.87	Facility		$1,747.02	$2,286.83	$2,381.87
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $307.45 / $594.87 / $4,460.97	Professional		$307.45	$594.87	$4,460.97
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 $312.32 / $1,867.56 / $3,885.61	Professional		$312.32	$1,867.56	$3,885.61
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 $2,442.15 / $3,740.28 / $5,363.24	Professional		$2,442.15	$3,740.28	$5,363.24