Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $264.89 / $4,178.10 / $18,711.00	Facility		$264.89	$4,178.10	$18,711.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $155.49 / $1,420.00 / $4,178.10	Professional		$155.49	$1,420.00	$4,178.10
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $2,837.33 / $18,231.29 / $37,102.31	Facility		$2,837.33	$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 $260.70 / $2,962.38 / $10,966.34	Professional		$260.70	$2,962.38	$10,966.34
Asuris Northwest Health Facility/Professional Professional Modifier 50 Low / Median / High Price $220.21 / $463.88 / $4,440.00	Professional	50	$220.21	$463.88	$4,440.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,015.22 / $2,015.22 / $3,357.33	Facility		$2,015.22	$2,015.22	$3,357.33
Cigna Facility/Professional Professional Modifier Low / Median / High Price $231.55 / $558.29 / $5,096.67	Professional		$231.55	$558.29	$5,096.67
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $222.90 / $2,428.84 / $8,788.10	Facility		$222.90	$2,428.84	$8,788.10
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 $222.28 / $2,122.46 / $5,483.66	Professional		$222.28	$2,122.46	$5,483.66
Molina Facility/Professional Professional Modifier Low / Median / High Price $404.05 / $2,543.82 / $4,208.88	Professional		$404.05	$2,543.82	$4,208.88
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $308.20 / $3,271.80 / $4,223.04	Facility		$308.20	$3,271.80	$4,223.04
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,732.06 / $2,232.90 / $2,329.33	Facility		$1,732.06	$2,232.90	$2,329.33
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $247.12 / $478.12 / $4,358.01	Professional		$247.12	$478.12	$4,358.01
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 $251.03 / $1,851.58 / $3,793.98	Professional		$251.03	$1,851.58	$3,793.98
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 $2,390.41 / $4,043.20 / $5,179.20	Professional		$2,390.41	$4,043.20	$5,179.20