Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $126.47 / $1,697.53 / $7,984.74	Facility		$126.47	$1,697.53	$7,984.74
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $3,129.00 / $3,129.00 / $3,129.00	Facility	50	$3,129.00	$3,129.00	$3,129.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $60.44 / $128.99 / $307.39	Professional		$60.44	$128.99	$307.39
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $314.87 / $2,583.03 / $11,500.00	Facility		$314.87	$2,583.03	$11,500.00
Asuris Northwest Health Facility/Professional Facility Modifier 50 Low / Median / High Price $2,799.32 / $3,874.55 / $7,495.73	Facility	50	$2,799.32	$3,874.55	$7,495.73
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $111.23 / $217.02 / $1,433.08	Professional		$111.23	$217.02	$1,433.08
Asuris Northwest Health Facility/Professional Professional Modifier 50 Low / Median / High Price $205.56 / $386.67 / $405.00	Professional	50	$205.56	$386.67	$405.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $466.83 / $568.48 / $1,132.06	Facility		$466.83	$568.48	$1,132.06
Cigna Facility/Professional Professional Modifier Low / Median / High Price $85.29 / $164.84 / $361.71	Professional		$85.29	$164.84	$361.71
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $82.21 / $163.69 / $840.73	Facility		$82.21	$163.69	$840.73
Kaiser Permanente Facility/Professional Facility Modifier 50 Low / Median / High Price $976.01 / $2,550.75 / $5,846.21	Facility	50	$976.01	$2,550.75	$5,846.21
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $82.21 / $161.87 / $491.14	Professional		$82.21	$161.87	$491.14
Molina Facility/Professional Professional Modifier Low / Median / High Price $36.02 / $202.03 / $355.12	Professional		$36.02	$202.03	$355.12
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $128.56 / $219.29 / $269.33	Facility		$128.56	$219.29	$269.33
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $151.76 / $183.71 / $927.31	Facility		$151.76	$183.71	$927.31
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $113.51 / $183.71 / $319.70	Professional		$113.51	$183.71	$319.70
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $1,674.98 / $2,581.55 / $4,941.05	Facility		$1,674.98	$2,581.55	$4,941.05
Regence BlueShield Facility/Professional Facility Modifier 50 Low / Median / High Price $2,512.46 / $3,872.33 / $7,411.58	Facility	50	$2,512.46	$3,872.33	$7,411.58
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $106.52 / $159.16 / $295.10	Professional		$106.52	$159.16	$295.10
United Facility/Professional Facility Modifier Low / Median / High Price $472.00 / $938.00 / $4,611.00	Facility		$472.00	$938.00	$4,611.00
United Facility/Professional Professional Modifier Low / Median / High Price $141.68 / $194.31 / $367.43	Professional		$141.68	$194.31	$367.43
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $71.95 / $110.15 / $147.33	Professional		$71.95	$110.15	$147.33