Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $869.00 / $1,410.17 / $12,519.50	Facility		$869.00	$1,410.17	$12,519.50
Aetna Facility/Professional Professional Modifier Low / Median / High Price $966.83 / $2,688.05 / $13,086.10	Professional		$966.83	$2,688.05	$13,086.10
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $4,131.74 / $29,304.00 / $59,636.26	Facility		$4,131.74	$29,304.00	$59,636.26
Asuris Northwest Health Facility/Professional Facility Modifier 50 Low / Median / High Price $35,720.43 / $46,764.08 / $90,470.07	Facility	50	$35,720.43	$46,764.08	$90,470.07
Asuris Northwest Health Facility/Professional Facility Modifier AS Low / Median / High Price $116.65 / $217.54 / $217.54	Facility	AS	$116.65	$217.54	$217.54
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $869.43 / $5,768.16 / $23,107.71	Professional		$869.43	$5,768.16	$23,107.71
Asuris Northwest Health Facility/Professional Professional Modifier 50 Low / Median / High Price $1,630.43 / $8,201.18 / $14,432.98	Professional	50	$1,630.43	$8,201.18	$14,432.98
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $778.80 / $6,881.64 / $13,074.78	Facility		$778.80	$6,881.64	$13,074.78
Kaiser Permanente Facility/Professional Facility Modifier 50 Low / Median / High Price $13,797.66 / $49,142.49 / $89,234.73	Facility	50	$13,797.66	$49,142.49	$89,234.73
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $762.27 / $5,505.31 / $12,065.77	Professional		$762.27	$5,505.31	$12,065.77
Molina Facility/Professional Professional Modifier Low / Median / High Price $750.63 / $4,587.95 / $7,659.66	Professional		$750.63	$4,587.95	$7,659.66
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,060.51 / $6,057.47 / $8,884.20	Facility		$1,060.51	$6,057.47	$8,884.20
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $4,131.74 / $4,131.74 / $4,375.07	Facility		$4,131.74	$4,131.74	$4,375.07
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $824.12 / $1,594.46 / $7,573.65	Professional		$824.12	$1,594.46	$7,573.65
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $22,748.67 / $31,176.05 / $59,636.26	Facility		$22,748.67	$31,176.05	$59,636.26
Regence BlueShield Facility/Professional Facility Modifier 50 Low / Median / High Price $34,123.01 / $46,764.08 / $89,454.39	Facility	50	$34,123.01	$46,764.08	$89,454.39
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $796.06 / $1,472.00 / $7,020.34	Professional		$796.06	$1,472.00	$7,020.34
United Facility/Professional Professional Modifier Low / Median / High Price $4,669.14 / $6,892.25 / $9,691.78	Professional		$4,669.14	$6,892.25	$9,691.78