Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $275.14 / $2,839.65 / $14,464.32	Facility		$275.14	$2,839.65	$14,464.32
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $4,334.75 / $4,334.75 / $4,334.75	Facility	50	$4,334.75	$4,334.75	$4,334.75
Aetna Facility/Professional Professional Modifier Low / Median / High Price $137.07 / $857.73 / $2,340.48	Professional		$137.07	$857.73	$2,340.48
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $676.20 / $4,521.04 / $9,200.71	Facility		$676.20	$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 $271.00 / $1,714.54 / $6,888.32	Professional		$271.00	$1,714.54	$6,888.32
Asuris Northwest Health Facility/Professional Professional Modifier 50 Low / Median / High Price $227.12 / $432.29 / $2,397.94	Professional	50	$227.12	$432.29	$2,397.94
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,107.40 / $1,107.40 / $1,844.92	Facility		$1,107.40	$1,107.40	$1,844.92
Cigna Facility/Professional Professional Modifier Low / Median / High Price $241.08 / $669.96 / $2,870.59	Professional		$241.08	$669.96	$2,870.59
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $229.99 / $1,243.03 / $2,793.82	Facility		$229.99	$1,243.03	$2,793.82
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 $229.14 / $1,166.33 / $2,572.03	Professional		$229.14	$1,166.33	$2,572.03
Molina Facility/Professional Professional Modifier Low / Median / High Price $222.94 / $1,435.96 / $2,384.57	Professional		$222.94	$1,435.96	$2,384.57
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $288.10 / $1,769.09 / $1,982.88	Facility		$288.10	$1,769.09	$1,982.88
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $676.20 / $1,280.51 / $1,320.95	Facility		$676.20	$1,280.51	$1,320.95
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $256.89 / $497.02 / $2,484.85	Professional		$256.89	$497.02	$2,484.85
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 $260.95 / $722.85 / $2,168.75	Professional		$260.95	$722.85	$2,168.75
United Facility/Professional Facility Modifier Low / Median / High Price $879.00 / $1,689.00 / $7,385.00	Facility		$879.00	$1,689.00	$7,385.00
United Facility/Professional Professional Modifier Low / Median / High Price $1,255.33 / $2,012.02 / $2,781.69	Professional		$1,255.33	$2,012.02	$2,781.69