Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $706.32 / $1,140.19 / $8,417.62	Facility		$706.32	$1,140.19	$8,417.62
Aetna Facility/Professional Professional Modifier Low / Median / High Price $781.73 / $2,175.56 / $8,813.65	Professional		$781.73	$2,175.56	$8,813.65
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $3,131.03 / $15,224.93 / $30,984.11	Facility		$3,131.03	$15,224.93	$30,984.11
Asuris Northwest Health Facility/Professional Facility Modifier 50 Low / Median / High Price $17,563.64 / $24,296.34 / $47,003.87	Facility	50	$17,563.64	$24,296.34	$47,003.87
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $705.73 / $4,698.87 / $18,044.80	Professional		$705.73	$4,698.87	$18,044.80
Asuris Northwest Health Facility/Professional Professional Modifier 50 Low / Median / High Price $1,101.72 / $1,344.00 / $9,767.93	Professional	50	$1,101.72	$1,344.00	$9,767.93
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $631.11 / $4,625.14 / $8,551.06	Facility		$631.11	$4,625.14	$8,551.06
Kaiser Permanente Facility/Professional Facility Modifier 50 Low / Median / High Price $13,797.66 / $24,314.18 / $44,150.58	Facility	50	$13,797.66	$24,314.18	$44,150.58
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $617.65 / $3,708.83 / $8,155.67	Professional		$617.65	$3,708.83	$8,155.67
Molina Facility/Professional Professional Modifier Low / Median / High Price $611.11 / $3,734.95 / $6,232.32	Professional		$611.11	$3,734.95	$6,232.32
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $789.26 / $4,640.88 / $5,889.76	Facility		$789.26	$4,640.88	$5,889.76
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $3,365.81 / $3,365.81 / $3,545.63	Facility		$3,365.81	$3,365.81	$3,545.63
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $668.95 / $1,294.25 / $6,169.66	Professional		$668.95	$1,294.25	$6,169.66
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $11,709.09 / $16,197.56 / $30,984.11	Facility		$11,709.09	$16,197.56	$30,984.11
Regence BlueShield Facility/Professional Facility Modifier 50 Low / Median / High Price $17,563.64 / $24,296.34 / $46,476.17	Facility	50	$17,563.64	$24,296.34	$46,476.17
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $648.19 / $1,194.84 / $5,700.51	Professional		$648.19	$1,194.84	$5,700.51
United Facility/Professional Professional Modifier Low / Median / High Price $3,612.41 / $4,947.47 / $7,663.55	Professional		$3,612.41	$4,947.47	$7,663.55