Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $372.42 / $607.65 / $7,046.65	Facility		$372.42	$607.65	$7,046.65
Aetna Facility/Professional Professional Modifier Low / Median / High Price $416.61 / $1,150.83 / $7,351.85	Professional		$416.61	$1,150.83	$7,351.85
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $55.00 / $1,704.15 / $2,022.84	Facility		$55.00	$1,704.15	$2,022.84
Asuris Northwest Health Facility/Professional Facility Modifier 50 Low / Median / High Price $17,563.64 / $17,563.64 / $17,563.64	Facility	50	$17,563.64	$17,563.64	$17,563.64
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $355.71 / $2,260.89 / $12,762.92	Professional		$355.71	$2,260.89	$12,762.92
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $326.25 / $2,254.63 / $6,453.72	Facility		$326.25	$2,254.63	$6,453.72
Kaiser Permanente Facility/Professional Facility Modifier 50 Low / Median / High Price $13,797.66 / $13,797.66 / $13,797.66	Facility	50	$13,797.66	$13,797.66	$13,797.66
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $327.92 / $2,254.63 / $6,403.87	Professional		$327.92	$2,254.63	$6,403.87
Molina Facility/Professional Professional Modifier Low / Median / High Price $309.95 / $1,894.49 / $3,160.41	Professional		$309.95	$1,894.49	$3,160.41
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $420.76 / $2,498.42 / $4,836.06	Facility		$420.76	$2,498.42	$4,836.06
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,704.15 / $1,704.15 / $1,807.92	Facility		$1,704.15	$1,704.15	$1,807.92
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $354.02 / $684.93 / $3,191.04	Professional		$354.02	$684.93	$3,191.04
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $9,294.04 / $9,294.04 / $11,709.09	Facility		$9,294.04	$9,294.04	$11,709.09
Regence BlueShield Facility/Professional Facility Modifier 50 Low / Median / High Price $13,941.08 / $13,941.08 / $17,563.64	Facility	50	$13,941.08	$13,941.08	$17,563.64
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $335.49 / $632.32 / $2,895.57	Professional		$335.49	$632.32	$2,895.57
United Facility/Professional Professional Modifier Low / Median / High Price $2,178.40 / $3,324.14 / $4,841.49	Professional		$2,178.40	$3,324.14	$4,841.49