Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $168.15 / $3,399.00 / $7,071.24	Facility		$168.15	$3,399.00	$7,071.24
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $6,422.40 / $6,422.40 / $6,422.40	Facility	50	$6,422.40	$6,422.40	$6,422.40
Aetna Facility/Professional Professional Modifier Low / Median / High Price $68.87 / $129.47 / $314.30	Professional		$68.87	$129.47	$314.30
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $594.72 / $4,594.55 / $11,887.47	Facility		$594.72	$4,594.55	$11,887.47
Asuris Northwest Health Facility/Professional Facility Modifier 50 Low / Median / High Price $5,034.33 / $6,891.83 / $13,332.98	Facility	50	$5,034.33	$6,891.83	$13,332.98
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $146.09 / $320.14 / $1,293.59	Professional		$146.09	$320.14	$1,293.59
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,007.00 / $1,007.00 / $1,677.65	Facility		$1,007.00	$1,007.00	$1,677.65
Cigna Facility/Professional Professional Modifier Low / Median / High Price $120.41 / $232.60 / $527.85	Professional		$120.41	$232.60	$527.85
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $111.18 / $206.42 / $1,436.99	Facility		$111.18	$206.42	$1,436.99
Kaiser Permanente Facility/Professional Facility Modifier 50 Low / Median / High Price $2,045.42 / $4,702.87 / $11,315.07	Facility	50	$2,045.42	$4,702.87	$11,315.07
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $111.00 / $192.68 / $558.73	Professional		$111.00	$192.68	$558.73
Molina Facility/Professional Professional Modifier Low / Median / High Price $42.95 / $278.39 / $452.59	Professional		$42.95	$278.39	$452.59
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $141.00 / $241.87 / $349.07	Facility		$141.00	$241.87	$349.07
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $238.10 / $241.45 / $625.69	Facility		$238.10	$241.45	$625.69
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $145.40 / $238.10 / $440.43	Professional		$145.40	$238.10	$440.43
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $2,979.36 / $4,591.92 / $8,788.86	Facility		$2,979.36	$4,591.92	$8,788.86
Regence BlueShield Facility/Professional Facility Modifier 50 Low / Median / High Price $4,469.04 / $6,887.88 / $13,183.29	Facility	50	$4,469.04	$6,887.88	$13,183.29
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $134.84 / $237.42 / $395.91	Professional		$134.84	$237.42	$395.91
United Facility/Professional Facility Modifier Low / Median / High Price $879.00 / $1,689.00 / $7,385.00	Facility		$879.00	$1,689.00	$7,385.00
United Facility/Professional Professional Modifier Low / Median / High Price $156.19 / $291.50 / $511.71	Professional		$156.19	$291.50	$511.71