Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $545.13 / $5,261.87 / $18,800.00	Facility		$545.13	$5,261.87	$18,800.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $438.87 / $1,312.45 / $4,790.14	Professional		$438.87	$1,312.45	$4,790.14
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $3,687.53 / $29,304.00 / $59,636.26	Facility		$3,687.53	$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 Professional Modifier Low / Median / High Price $741.43 / $4,937.42 / $19,771.20	Professional		$741.43	$4,937.42	$19,771.20
Cigna Facility/Professional Facility Modifier Low / Median / High Price $16,638.29 / $16,638.29 / $16,638.29	Facility		$16,638.29	$16,638.29	$16,638.29
Cigna Facility/Professional Professional Modifier Low / Median / High Price $678.19 / $1,372.90 / $8,369.86	Professional		$678.19	$1,372.90	$8,369.86
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $700.87 / $4,996.10 / $11,071.55	Facility		$700.87	$4,996.10	$11,071.55
Kaiser Permanente Facility/Professional Facility Modifier 50 Low / Median / High Price $33,286.90 / $49,142.49 / $89,234.73	Facility	50	$33,286.90	$49,142.49	$89,234.73
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $686.40 / $3,827.57 / $9,729.43	Professional		$686.40	$3,827.57	$9,729.43
Molina Facility/Professional Professional Modifier Low / Median / High Price $671.72 / $4,094.77 / $6,855.38	Professional		$671.72	$4,094.77	$6,855.38
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $865.64 / $5,149.24 / $7,499.98	Facility		$865.64	$5,149.24	$7,499.98
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $3,687.53 / $3,687.53 / $3,887.65	Facility		$3,687.53	$3,687.53	$3,887.65
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $737.91 / $1,427.68 / $6,759.40	Professional		$737.91	$1,427.68	$6,759.40
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 $707.55 / $1,318.03 / $6,257.18	Professional		$707.55	$1,318.03	$6,257.18
United Facility/Professional Facility Modifier Low / Median / High Price $3,340.00 / $13,441.00 / $26,100.00	Facility		$3,340.00	$13,441.00	$26,100.00
United Facility/Professional Professional Modifier Low / Median / High Price $4,026.96 / $5,841.07 / $8,404.14	Professional		$4,026.96	$5,841.07	$8,404.14