Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $274.49 / $704.21 / $14,464.32	Facility		$274.49	$704.21	$14,464.32
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $4,460.09 / $4,460.09 / $4,460.09	Facility	50	$4,460.09	$4,460.09	$4,460.09
Aetna Facility/Professional Professional Modifier Low / Median / High Price $137.07 / $274.49 / $682.38	Professional		$137.07	$274.49	$682.38
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $1,143.07 / $1,143.07 / $1,143.07	Professional	50	$1,143.07	$1,143.07	$1,143.07
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $206.89 / $4,521.04 / $9,200.71	Facility		$206.89	$4,521.04	$9,200.71
Asuris Northwest Health Facility/Professional Facility Modifier 50 Low / Median / High Price $5,510.97 / $7,214.79 / $13,957.79	Facility	50	$5,510.97	$7,214.79	$13,957.79
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $269.80 / $550.30 / $2,133.60	Professional		$269.80	$550.30	$2,133.60
Asuris Northwest Health Facility/Professional Professional Modifier 50 Low / Median / High Price $227.12 / $430.86 / $818.69	Professional	50	$227.12	$430.86	$818.69
Cigna Facility/Professional Facility Modifier Low / Median / High Price $265.81 / $265.81 / $442.84	Facility		$265.81	$265.81	$442.84
Cigna Facility/Professional Professional Modifier Low / Median / High Price $240.09 / $442.76 / $875.07	Professional		$240.09	$442.76	$875.07
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $223.87 / $374.64 / $930.00	Facility		$223.87	$374.64	$930.00
Kaiser Permanente Facility/Professional Facility Modifier 50 Low / Median / High Price $4,634.72 / $4,829.01 / $11,618.58	Facility	50	$4,634.72	$4,829.01	$11,618.58
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $223.87 / $372.37 / $678.55	Professional		$223.87	$372.37	$678.55
Molina Facility/Professional Professional Modifier Low / Median / High Price $69.52 / $442.65 / $722.75	Professional		$69.52	$442.65	$722.75
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $288.10 / $523.94 / $579.54	Facility		$288.10	$523.94	$579.54
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $206.89 / $388.67 / $395.31	Facility		$206.89	$388.67	$395.31
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $265.62 / $403.66 / $724.61	Professional		$265.62	$403.66	$724.61
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $3,509.68 / $4,807.10 / $9,200.71	Facility		$3,509.68	$4,807.10	$9,200.71
Regence BlueShield Facility/Professional Facility Modifier 50 Low / Median / High Price $5,264.52 / $7,210.67 / $13,801.08	Facility	50	$5,264.52	$7,210.67	$13,801.08
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $252.10 / $396.40 / $669.51	Professional		$252.10	$396.40	$669.51
United Facility/Professional Facility Modifier Low / Median / High Price $3,740.00 / $6,167.72 / $9,865.41	Facility		$3,740.00	$6,167.72	$9,865.41
United Facility/Professional Professional Modifier Low / Median / High Price $346.38 / $622.24 / $837.08	Professional		$346.38	$622.24	$837.08