Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $474.92 / $1,417.04 / $17,100.00	Facility		$474.92	$1,417.04	$17,100.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $283.07 / $663.36 / $1,264.33	Professional		$283.07	$663.36	$1,264.33
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $1,818.30 / $9,879.37 / $18,898.13	Facility		$1,818.30	$9,879.37	$18,898.13
Asuris Northwest Health Facility/Professional Facility Modifier 50 Low / Median / High Price $10,712.31 / $14,819.07 / $28,669.05	Facility	50	$10,712.31	$14,819.07	$28,669.05
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $448.09 / $1,093.77 / $9,121.74	Professional		$448.09	$1,093.77	$9,121.74
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,353.44 / $2,353.44 / $3,920.80	Facility		$2,353.44	$2,353.44	$3,920.80
Cigna Facility/Professional Professional Modifier Low / Median / High Price $417.27 / $771.48 / $1,834.40	Professional		$417.27	$771.48	$1,834.40
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $416.38 / $767.81 / $3,140.04	Facility		$416.38	$767.81	$3,140.04
Kaiser Permanente Facility/Professional Facility Modifier 50 Low / Median / High Price $6,620.15 / $9,669.36 / $23,264.42	Facility	50	$6,620.15	$9,669.36	$23,264.42
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $410.92 / $715.00 / $1,946.25	Professional		$410.92	$715.00	$1,946.25
Molina Facility/Professional Professional Modifier Low / Median / High Price $153.74 / $984.18 / $1,601.82	Professional		$153.74	$984.18	$1,601.82
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $537.70 / $1,045.38 / $1,247.11	Facility		$537.70	$1,045.38	$1,247.11
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $824.43 / $830.80 / $1,470.05	Facility		$824.43	$830.80	$1,470.05
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $445.97 / $789.25 / $1,565.15	Professional		$445.97	$789.25	$1,565.15
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $6,406.33 / $9,873.73 / $18,898.13	Facility		$6,406.33	$9,873.73	$18,898.13
Regence BlueShield Facility/Professional Facility Modifier 50 Low / Median / High Price $9,609.50 / $14,810.60 / $28,347.20	Facility	50	$9,609.50	$14,810.60	$28,347.20
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $413.57 / $796.56 / $1,400.81	Professional		$413.57	$796.56	$1,400.81
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 $729.53 / $1,319.28 / $1,746.59	Professional		$729.53	$1,319.28	$1,746.59