Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $338.48 / $6,116.40 / $18,359.89	Facility		$338.48	$6,116.40	$18,359.89
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $781.85 / $9,940.50 / $13,518.52	Facility	50	$781.85	$9,940.50	$13,518.52
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $98.60 / $223.69 / $666.00	Facility	52	$98.60	$223.69	$666.00
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $39.44 / $89.48 / $266.39	Facility	53	$39.44	$89.48	$266.39
Aetna Facility/Professional Professional Modifier Low / Median / High Price $145.77 / $350.91 / $907.83	Professional		$145.77	$350.91	$907.83
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $139.72 / $292.83 / $1,028.00	Professional	50	$139.72	$292.83	$1,028.00
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $718.52 / $9,879.37 / $18,898.13	Facility		$718.52	$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 Facility Modifier 52 Low / Median / High Price $316.89 / $775.66 / $775.66	Facility	52	$316.89	$775.66	$775.66
Asuris Northwest Health Facility/Professional Facility Modifier 53 Low / Median / High Price $79.23 / $193.91 / $193.91	Facility	53	$79.23	$193.91	$193.91
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $278.89 / $762.80 / $4,483.93	Professional		$278.89	$762.80	$4,483.93
Asuris Northwest Health Facility/Professional Professional Modifier 50 Low / Median / High Price $238.78 / $647.54 / $1,073.70	Professional	50	$238.78	$647.54	$1,073.70
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 $247.78 / $503.26 / $1,222.23	Professional		$247.78	$503.26	$1,222.23
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $245.25 / $727.57 / $3,140.04	Facility		$245.25	$727.57	$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 $243.39 / $602.64 / $1,305.93	Professional		$243.39	$602.64	$1,305.93
Molina Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $608.98 / $996.01	Professional		$95.50	$608.98	$996.01
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $314.72 / $789.33 / $932.64	Facility		$314.72	$789.33	$932.64
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $547.94 / $554.02 / $1,470.05	Facility		$547.94	$554.02	$1,470.05
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $264.36 / $511.47 / $1,042.57	Professional		$264.36	$511.47	$1,042.57
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 $245.02 / $495.56 / $931.02	Professional		$245.02	$495.56	$931.02
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 $543.90 / $821.28 / $1,222.47	Professional		$543.90	$821.28	$1,222.47