Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $702.53 / $5,730.00 / $17,930.00	Facility		$702.53	$5,730.00	$17,930.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $6,398.19 / $15,501.84 / $30,424.53	Facility	50	$6,398.19	$15,501.84	$30,424.53
Aetna Facility/Professional Professional Modifier Low / Median / High Price $387.00 / $562.24 / $1,256.70	Professional		$387.00	$562.24	$1,256.70
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $3,412.57 / $10,802.03 / $20,663.07	Facility		$3,412.57	$10,802.03	$20,663.07
Asuris Northwest Health Facility/Professional Facility Modifier 50 Low / Median / High Price $10,306.59 / $16,203.05 / $31,346.52	Facility	50	$10,306.59	$16,203.05	$31,346.52
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $716.93 / $1,142.02 / $3,896.24	Professional		$716.93	$1,142.02	$3,896.24
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,186.71 / $2,186.71 / $3,643.05	Facility		$2,186.71	$2,186.71	$3,643.05
Cigna Facility/Professional Professional Modifier Low / Median / High Price $612.44 / $999.87 / $1,586.93	Professional		$612.44	$999.87	$1,586.93
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $520.38 / $954.80 / $3,225.00	Facility		$520.38	$954.80	$3,225.00
Kaiser Permanente Facility/Professional Facility Modifier 50 Low / Median / High Price $6,300.19 / $9,505.52 / $22,870.24	Facility	50	$6,300.19	$9,505.52	$22,870.24
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $564.82 / $939.16 / $1,646.25	Professional		$564.82	$939.16	$1,646.25
Molina Facility/Professional Professional Modifier Low / Median / High Price $94.72 / $598.58 / $1,208.88	Professional		$94.72	$598.58	$1,208.88
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $679.95 / $993.61 / $1,065.97	Facility		$679.95	$993.61	$1,065.97
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $717.10 / $727.09 / $1,239.50	Facility		$717.10	$727.09	$1,239.50
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $716.93 / $992.67 / $1,383.31	Professional		$716.93	$992.67	$1,383.31
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $7,004.63 / $10,795.86 / $20,663.07	Facility		$7,004.63	$10,795.86	$20,663.07
Regence BlueShield Facility/Professional Facility Modifier 50 Low / Median / High Price $10,506.95 / $16,193.79 / $30,994.61	Facility	50	$10,506.95	$16,193.79	$30,994.61
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $675.28 / $928.79 / $1,291.33	Professional		$675.28	$928.79	$1,291.33
United Facility/Professional Facility Modifier Low / Median / High Price $1,550.00 / $2,431.00 / $11,261.00	Facility		$1,550.00	$2,431.00	$11,261.00
United Facility/Professional Professional Modifier Low / Median / High Price $648.07 / $1,121.11 / $1,535.16	Professional		$648.07	$1,121.11	$1,535.16