Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $180.27 / $2,291.00 / $7,984.74	Facility		$180.27	$2,291.00	$7,984.74
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $2,668.42 / $5,707.69 / $9,341.25	Facility	50	$2,668.42	$5,707.69	$9,341.25
Aetna Facility/Professional Professional Modifier Low / Median / High Price $105.76 / $396.32 / $1,239.27	Professional		$105.76	$396.32	$1,239.27
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $804.32 / $5,425.50 / $11,041.39	Facility		$804.32	$5,425.50	$11,041.39
Asuris Northwest Health Facility/Professional Facility Modifier 50 Low / Median / High Price $6,367.49 / $8,658.17 / $16,750.13	Facility	50	$6,367.49	$8,658.17	$16,750.13
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $177.04 / $1,076.94 / $4,336.96	Professional		$177.04	$1,076.94	$4,336.96
Asuris Northwest Health Facility/Professional Professional Modifier 50 Low / Median / High Price $153.01 / $287.85 / $1,729.50	Professional	50	$153.01	$287.85	$1,729.50
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 $157.65 / $550.55 / $1,802.97	Professional		$157.65	$550.55	$1,802.97
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $158.05 / $717.76 / $1,914.35	Facility		$158.05	$717.76	$1,914.35
Kaiser Permanente Facility/Professional Facility Modifier 50 Low / Median / High Price $1,914.35 / $2,768.63 / $5,552.03	Facility	50	$1,914.35	$2,768.63	$5,552.03
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $156.83 / $574.21 / $1,531.84	Professional		$156.83	$574.21	$1,531.84
Molina Facility/Professional Professional Modifier Low / Median / High Price $147.70 / $937.40 / $1,553.84	Professional		$147.70	$937.40	$1,553.84
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $195.64 / $1,045.51 / $1,218.73	Facility		$195.64	$1,045.51	$1,218.73
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $804.32 / $839.66 / $846.66	Facility		$804.32	$839.66	$846.66
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $167.81 / $324.67 / $1,573.80	Professional		$167.81	$324.67	$1,573.80
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $3,742.95 / $5,768.81 / $11,041.39	Facility		$3,742.95	$5,768.81	$11,041.39
Regence BlueShield Facility/Professional Facility Modifier 50 Low / Median / High Price $5,614.43 / $8,653.21 / $16,562.09	Facility	50	$5,614.43	$8,653.21	$16,562.09
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $157.24 / $711.79 / $1,362.24	Professional		$157.24	$711.79	$1,362.24
United Facility/Professional Facility Modifier Low / Median / High Price $591.00 / $1,106.00 / $4,911.00	Facility		$591.00	$1,106.00	$4,911.00
United Facility/Professional Professional Modifier Low / Median / High Price $673.26 / $993.87 / $1,728.06	Professional		$673.26	$993.87	$1,728.06