Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $761.72 / $4,371.70 / $24,258.74	Facility		$761.72	$4,371.70	$24,258.74
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $17,000.00 / $17,000.00 / $17,000.00	Facility	50	$17,000.00	$17,000.00	$17,000.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $443.87 / $1,784.45 / $3,641.68	Professional		$443.87	$1,784.45	$3,641.68
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $365.54 / $365.54 / $365.54	Professional		$365.54	$365.54	$365.54
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $2,296.42 / $42,647.08 / $95,056.24	Facility		$2,296.42	$42,647.08	$95,056.24
Asuris Northwest Health Facility/Professional Facility Modifier 50 Low / Median / High Price $30,202.68 / $74,496.23 / $144,203.29	Facility	50	$30,202.68	$74,496.23	$144,203.29
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $734.13 / $3,205.95 / $14,607.75	Professional		$734.13	$3,205.95	$14,607.75
Cigna Facility/Professional Facility Modifier Low / Median / High Price $28,288.37 / $28,288.37 / $28,288.37	Facility		$28,288.37	$28,288.37	$28,288.37
Cigna Facility/Professional Professional Modifier Low / Median / High Price $669.96 / $2,629.37 / $5,131.09	Professional		$669.96	$2,629.37	$5,131.09
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $705.77 / $3,353.29 / $13,861.86	Facility		$705.77	$3,353.29	$13,861.86
Kaiser Permanente Facility/Professional Facility Modifier 50 Low / Median / High Price $10,488.49 / $19,774.45 / $50,029.96	Facility	50	$10,488.49	$19,774.45	$50,029.96
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $693.53 / $2,682.63 / $6,329.80	Professional		$693.53	$2,682.63	$6,329.80
Molina Facility/Professional Professional Modifier Low / Median / High Price $420.02 / $2,569.25 / $4,277.51	Professional		$420.02	$2,569.25	$4,277.51
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $943.60 / $3,366.75 / $4,292.68	Facility		$943.60	$3,366.75	$4,292.68
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,296.42 / $2,296.42 / $2,414.48	Facility		$2,296.42	$2,296.42	$2,414.48
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $721.25 / $1,395.43 / $4,209.43	Professional		$721.25	$1,395.43	$4,209.43
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $20,135.12 / $46,708.63 / $95,056.24	Facility		$20,135.12	$46,708.63	$95,056.24
Regence BlueShield Facility/Professional Facility Modifier 50 Low / Median / High Price $30,202.68 / $70,062.95 / $142,584.35	Facility	50	$30,202.68	$70,062.95	$142,584.35
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $710.99 / $1,288.26 / $3,889.35	Professional		$710.99	$1,288.26	$3,889.35
United Facility/Professional Facility Modifier Low / Median / High Price $3,028.00 / $11,540.00 / $20,708.00	Facility		$3,028.00	$11,540.00	$20,708.00
United Facility/Professional Professional Modifier Low / Median / High Price $2,464.44 / $3,631.27 / $5,224.68	Professional		$2,464.44	$3,631.27	$5,224.68