Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $368.60 / $2,792.00 / $10,809.00	Facility		$368.60	$2,792.00	$10,809.00
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $129.34 / $299.69 / $1,113.80	Facility	52	$129.34	$299.69	$1,113.80
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $51.73 / $119.87 / $445.52	Facility	53	$51.73	$119.87	$445.52
Aetna Facility/Professional Professional Modifier Low / Median / High Price $235.53 / $654.77 / $1,744.84	Professional		$235.53	$654.77	$1,744.84
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $839.66 / $5,425.50 / $11,041.39	Facility		$839.66	$5,425.50	$11,041.39
Asuris Northwest Health Facility/Professional Facility Modifier 50 Low / Median / High Price $6,576.66 / $8,658.17 / $16,750.13	Facility	50	$6,576.66	$8,658.17	$16,750.13
Asuris Northwest Health Facility/Professional Facility Modifier 52 Low / Median / High Price $414.00 / $727.83 / $727.83	Facility	52	$414.00	$727.83	$727.83
Asuris Northwest Health Facility/Professional Facility Modifier 53 Low / Median / High Price $103.50 / $181.96 / $181.96	Facility	53	$103.50	$181.96	$181.96
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $361.35 / $1,635.61 / $6,599.52	Professional		$361.35	$1,635.61	$6,599.52
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,364.71 / $1,364.71 / $2,273.59	Facility		$1,364.71	$1,364.71	$2,273.59
Cigna Facility/Professional Professional Modifier Low / Median / High Price $321.11 / $669.96 / $2,731.60	Professional		$321.11	$669.96	$2,731.60
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $325.36 / $1,114.09 / $2,279.02	Facility		$325.36	$1,114.09	$2,279.02
Kaiser Permanente Facility/Professional Facility Modifier 50 Low / Median / High Price $5,498.43 / $6,254.64 / $15,048.64	Facility	50	$5,498.43	$6,254.64	$15,048.64
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $321.81 / $938.77 / $2,242.03	Professional		$321.81	$938.77	$2,242.03
Molina Facility/Professional Professional Modifier Low / Median / High Price $226.04 / $1,436.96 / $2,366.18	Professional		$226.04	$1,436.96	$2,366.18
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $403.34 / $1,599.89 / $1,885.64	Facility		$403.34	$1,599.89	$1,885.64
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $839.66 / $1,221.56 / $1,268.84	Facility		$839.66	$1,221.56	$1,268.84
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $342.52 / $662.69 / $2,374.11	Professional		$342.52	$662.69	$2,374.11
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $4,211.81 / $5,768.81 / $11,041.39	Facility		$4,211.81	$5,768.81	$11,041.39
Regence BlueShield Facility/Professional Facility Modifier 50 Low / Median / High Price $6,317.72 / $8,653.21 / $16,562.09	Facility	50	$6,317.72	$8,653.21	$16,562.09
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $322.02 / $897.60 / $2,068.90	Professional		$322.02	$897.60	$2,068.90
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 $1,113.21 / $1,934.79 / $2,649.32	Professional		$1,113.21	$1,934.79	$2,649.32