Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $504.09 / $2,966.03 / $17,100.00	Facility		$504.09	$2,966.03	$17,100.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $304.52 / $1,119.82 / $2,365.14	Professional		$304.52	$1,119.82	$2,365.14
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $2,228.54 / $7,150.94 / $11,933.63	Facility		$2,228.54	$7,150.94	$11,933.63
Asuris Northwest Health Facility/Professional Facility Modifier 50 Low / Median / High Price $9,691.19 / $13,549.47 / $26,212.89	Facility	50	$9,691.19	$13,549.47	$26,212.89
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $484.59 / $2,243.01 / $8,922.64	Professional		$484.59	$2,243.01	$8,922.64
Asuris Northwest Health Facility/Professional Professional Modifier 50 Low / Median / High Price $675.08 / $1,896.60 / $3,588.15	Professional	50	$675.08	$1,896.60	$3,588.15
Cigna Facility/Professional Professional Modifier Low / Median / High Price $361.48 / $896.79 / $3,423.07	Professional		$361.48	$896.79	$3,423.07
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $405.50 / $1,490.65 / $4,009.68	Facility		$405.50	$1,490.65	$4,009.68
Kaiser Permanente Facility/Professional Facility Modifier 50 Low / Median / High Price $8,105.48 / $11,895.06 / $21,599.49	Facility	50	$8,105.48	$11,895.06	$21,599.49
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $396.96 / $1,068.57 / $3,443.32	Professional		$396.96	$1,068.57	$3,443.32
Molina Facility/Professional Professional Modifier Low / Median / High Price $315.09 / $1,878.10 / $3,171.10	Professional		$315.09	$1,878.10	$3,171.10
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,176.50 / $2,332.17 / $2,520.08	Facility		$1,176.50	$2,332.17	$2,520.08
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,668.51 / $1,668.51 / $1,678.82	Facility		$1,668.51	$1,668.51	$1,678.82
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $502.59 / $1,668.51 / $3,311.82	Professional		$502.59	$1,668.51	$3,311.82
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $6,460.79 / $9,027.82 / $17,279.07	Facility		$6,460.79	$9,027.82	$17,279.07
Regence BlueShield Facility/Professional Facility Modifier 50 Low / Median / High Price $9,691.19 / $13,541.73 / $25,918.61	Facility	50	$9,691.19	$13,541.73	$25,918.61
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $510.25 / $1,049.38 / $2,915.93	Professional		$510.25	$1,049.38	$2,915.93
United Facility/Professional Facility Modifier Low / Median / High Price $2,155.00 / $3,623.00 / $12,835.00	Facility		$2,155.00	$3,623.00	$12,835.00
United Facility/Professional Professional Modifier Low / Median / High Price $1,386.45 / $2,334.19 / $3,531.79	Professional		$1,386.45	$2,334.19	$3,531.79
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $287.80 / $287.80 / $1,362.37	Professional		$287.80	$287.80	$1,362.37