Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $786.81 / $12,814.00 / $23,242.62	Facility		$786.81	$12,814.00	$23,242.62
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $1,152.40 / $16,325.53 / $27,536.36	Facility	50	$1,152.40	$16,325.53	$27,536.36
Aetna Facility/Professional Professional Modifier Low / Median / High Price $404.20 / $523.86 / $1,481.04	Professional		$404.20	$523.86	$1,481.04
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $545.41 / $14,302.50 / $28,049.69	Facility		$545.41	$14,302.50	$28,049.69
Asuris Northwest Health Facility/Professional Facility Modifier 50 Low / Median / High Price $14,715.18 / $21,995.31 / $42,552.26	Facility	50	$14,715.18	$21,995.31	$42,552.26
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $575.77 / $958.63 / $3,481.20	Professional		$575.77	$958.63	$3,481.20
Cigna Facility/Professional Facility Modifier Low / Median / High Price $3,585.08 / $3,585.08 / $5,972.71	Facility		$3,585.08	$3,585.08	$5,972.71
Cigna Facility/Professional Professional Modifier Low / Median / High Price $535.90 / $837.62 / $1,231.02	Professional		$535.90	$837.62	$1,231.02
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $510.55 / $929.81 / $12,060.66	Facility		$510.55	$929.81	$12,060.66
Kaiser Permanente Facility/Professional Facility Modifier 50 Low / Median / High Price $12,060.66 / $13,249.69 / $31,878.69	Facility	50	$12,060.66	$13,249.69	$31,878.69
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $510.55 / $910.48 / $4,024.14	Professional		$510.55	$910.48	$4,024.14
Molina Facility/Professional Professional Modifier Low / Median / High Price $100.89 / $646.72 / $1,057.30	Professional		$100.89	$646.72	$1,057.30
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $638.12 / $799.10 / $820.08	Facility		$638.12	$799.10	$820.08
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $545.41 / $559.37 / $2,173.03	Facility		$545.41	$559.37	$2,173.03
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $575.77 / $933.06 / $1,147.26	Professional		$575.77	$933.06	$1,147.26
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $9,617.14 / $14,655.16 / $28,049.69	Facility		$9,617.14	$14,655.16	$28,049.69
Regence BlueShield Facility/Professional Facility Modifier 50 Low / Median / High Price $14,425.71 / $21,982.74 / $42,074.54	Facility	50	$14,425.71	$21,982.74	$42,074.54
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $556.25 / $804.66 / $1,083.84	Professional		$556.25	$804.66	$1,083.84
United Facility/Professional Facility Modifier Low / Median / High Price $2,912.00 / $3,509.00 / $17,644.00	Facility		$2,912.00	$3,509.00	$17,644.00
United Facility/Professional Professional Modifier Low / Median / High Price $533.75 / $874.70 / $1,169.21	Professional		$533.75	$874.70	$1,169.21