Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $149.02 / $2,064.40 / $18,711.00	Facility		$149.02	$2,064.40	$18,711.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $2,612.60 / $2,612.60 / $4,122.02	Facility	50	$2,612.60	$2,612.60	$4,122.02
Aetna Facility/Professional Professional Modifier Low / Median / High Price $79.68 / $207.97 / $480.75	Professional		$79.68	$207.97	$480.75
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $220.42 / $298.85 / $298.85	Professional	50	$220.42	$298.85	$298.85
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $238.22 / $1,836.95 / $3,748.81	Facility		$238.22	$1,836.95	$3,748.81
Asuris Northwest Health Facility/Professional Facility Modifier 50 Low / Median / High Price $2,285.07 / $2,939.66 / $5,687.07	Facility	50	$2,285.07	$2,939.66	$5,687.07
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $140.32 / $426.95 / $1,886.00	Professional		$140.32	$426.95	$1,886.00
Asuris Northwest Health Facility/Professional Professional Modifier 50 Low / Median / High Price $240.86 / $248.57 / $688.50	Professional	50	$240.86	$248.57	$688.50
Cigna Facility/Professional Facility Modifier Low / Median / High Price $714.97 / $870.49 / $880.53	Facility		$714.97	$870.49	$880.53
Cigna Facility/Professional Professional Modifier Low / Median / High Price $104.62 / $242.96 / $646.48	Professional		$104.62	$242.96	$646.48
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $103.28 / $258.25 / $660.80	Facility		$103.28	$258.25	$660.80
Kaiser Permanente Facility/Professional Facility Modifier 50 Low / Median / High Price $1,928.64 / $2,377.07 / $5,719.21	Facility	50	$1,928.64	$2,377.07	$5,719.21
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $103.28 / $245.55 / $600.33	Professional		$103.28	$245.55	$600.33
Molina Facility/Professional Professional Modifier Low / Median / High Price $63.75 / $357.24 / $628.33	Professional		$63.75	$357.24	$628.33
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $162.81 / $413.69 / $458.28	Facility		$162.81	$413.69	$458.28
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $238.22 / $312.58 / $715.32	Facility		$238.22	$312.58	$715.32
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $135.66 / $270.19 / $568.45	Professional		$135.66	$270.19	$568.45
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $1,443.99 / $1,959.77 / $3,748.81	Facility		$1,443.99	$1,959.77	$3,748.81
Regence BlueShield Facility/Professional Facility Modifier 50 Low / Median / High Price $2,165.98 / $2,939.66 / $5,623.22	Facility	50	$2,165.98	$2,939.66	$5,623.22
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $128.01 / $272.14 / $539.05	Professional		$128.01	$272.14	$539.05
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 $251.58 / $341.43 / $621.78	Professional		$251.58	$341.43	$621.78
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $86.60 / $185.52 / $254.71	Professional		$86.60	$185.52	$254.71