Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $381.40 / $8,369.76 / $18,711.00	Facility		$381.40	$8,369.76	$18,711.00
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $190.70 / $325.05 / $434.51	Facility	52	$190.70	$325.05	$434.51
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $76.28 / $130.02 / $173.80	Facility	53	$76.28	$130.02	$173.80
Aetna Facility/Professional Professional Modifier Low / Median / High Price $309.07 / $381.40 / $864.90	Professional		$309.07	$381.40	$864.90
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $5,555.74 / $9,879.37 / $25,560.89	Facility		$5,555.74	$9,879.37	$25,560.89
Asuris Northwest Health Facility/Professional Facility Modifier 52 Low / Median / High Price $4,280.30 / $7,119.48 / $7,119.48	Facility	52	$4,280.30	$7,119.48	$7,119.48
Asuris Northwest Health Facility/Professional Facility Modifier 53 Low / Median / High Price $1,070.08 / $1,779.87 / $1,779.87	Facility	53	$1,070.08	$1,779.87	$1,779.87
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $420.07 / $694.75 / $2,853.12	Professional		$420.07	$694.75	$2,853.12
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 $377.85 / $610.58 / $898.53	Professional		$377.85	$610.58	$898.53
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $371.77 / $716.35 / $6,254.64	Facility		$371.77	$716.35	$6,254.64
Kaiser Permanente Facility/Professional Facility Modifier 50 Low / Median / High Price $6,254.64 / $8,287.44 / $15,048.64	Facility	50	$6,254.64	$8,287.44	$15,048.64
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $381.84 / $670.40 / $2,641.65	Professional		$381.84	$670.40	$2,641.65
Molina Facility/Professional Professional Modifier Low / Median / High Price $83.98 / $537.18 / $879.90	Professional		$83.98	$537.18	$879.90
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $443.21 / $582.97 / $599.98	Facility		$443.21	$582.97	$599.98
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $396.83 / $408.10 / $1,470.05	Facility		$396.83	$408.10	$1,470.05
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $425.92 / $680.73 / $837.01	Professional		$425.92	$680.73	$837.01
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $6,079.47 / $9,873.73 / $18,898.13	Facility		$6,079.47	$9,873.73	$18,898.13
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $404.71 / $586.62 / $790.75	Professional		$404.71	$586.62	$790.75
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 $383.24 / $567.45 / $860.77	Professional		$383.24	$567.45	$860.77