Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $573.98 / $3,016.00 / $17,100.00	Facility		$573.98	$3,016.00	$17,100.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $4,188.00 / $16,484.00 / $16,484.00	Facility	50	$4,188.00	$16,484.00	$16,484.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $284.02 / $1,213.57 / $2,807.65	Professional		$284.02	$1,213.57	$2,807.65
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $2,934.20 / $7,150.94 / $11,933.63	Facility		$2,934.20	$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 $538.41 / $2,722.05 / $11,504.00	Professional		$538.41	$2,722.05	$11,504.00
Asuris Northwest Health Facility/Professional Professional Modifier 50 Low / Median / High Price $747.93 / $2,351.31 / $4,312.31	Professional	50	$747.93	$2,351.31	$4,312.31
Cigna Facility/Professional Professional Modifier Low / Median / High Price $401.93 / $1,023.78 / $4,381.68	Professional		$401.93	$1,023.78	$4,381.68
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $450.00 / $1,764.23 / $4,365.82	Facility		$450.00	$1,764.23	$4,365.82
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 $440.64 / $1,288.67 / $4,061.78	Professional		$440.64	$1,288.67	$4,061.78
Molina Facility/Professional Professional Modifier Low / Median / High Price $429.02 / $2,569.41 / $4,331.03	Professional		$429.02	$2,569.41	$4,331.03
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,549.79 / $2,844.72 / $3,158.38	Facility		$1,549.79	$2,844.72	$3,158.38
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,109.17 / $2,109.17 / $2,154.30	Facility		$2,109.17	$2,109.17	$2,154.30
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $576.01 / $2,145.34 / $4,128.12	Professional		$576.01	$2,145.34	$4,128.12
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 $582.40 / $1,202.68 / $3,648.64	Professional		$582.40	$1,202.68	$3,648.64
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 $1,678.49 / $2,755.37 / $4,426.04	Professional		$1,678.49	$2,755.37	$4,426.04
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $332.81 / $332.81 / $1,802.00	Professional		$332.81	$332.81	$1,802.00