Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $555.50 / $2,369.36 / $20,680.40	Facility		$555.50	$2,369.36	$20,680.40
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $11,792.99 / $12,312.52 / $19,186.00	Facility	50	$11,792.99	$12,312.52	$19,186.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $375.62 / $823.84 / $1,832.22	Professional		$375.62	$823.84	$1,832.22
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $516.03 / $1,068.65 / $1,502.03	Professional	50	$516.03	$1,068.65	$1,502.03
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $2,119.56 / $18,951.30 / $37,074.37	Facility		$2,119.56	$18,951.30	$37,074.37
Asuris Northwest Health Facility/Professional Facility Modifier 50 Low / Median / High Price $21,885.08 / $29,072.06 / $56,243.00	Facility	50	$21,885.08	$29,072.06	$56,243.00
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $534.04 / $1,365.37 / $7,602.97	Professional		$534.04	$1,365.37	$7,602.97
Asuris Northwest Health Facility/Professional Professional Modifier 50 Low / Median / High Price $908.79 / $1,468.50 / $2,215.50	Professional	50	$908.79	$1,468.50	$2,215.50
Cigna Facility/Professional Facility Modifier Low / Median / High Price $714.97 / $870.49 / $12,358.81	Facility		$714.97	$870.49	$12,358.81
Cigna Facility/Professional Professional Modifier Low / Median / High Price $400.22 / $926.80 / $2,132.75	Professional		$400.22	$926.80	$2,132.75
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $463.12 / $1,055.56 / $8,326.79	Facility		$463.12	$1,055.56	$8,326.79
Kaiser Permanente Facility/Professional Facility Modifier 50 Low / Median / High Price $16,618.52 / $21,848.65 / $52,567.76	Facility	50	$16,618.52	$21,848.65	$52,567.76
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $444.53 / $983.59 / $5,361.87	Professional		$444.53	$983.59	$5,361.87
Molina Facility/Professional Professional Modifier Low / Median / High Price $131.03 / $758.77 / $1,626.79	Professional		$131.03	$758.77	$1,626.79
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $706.01 / $1,402.94 / $1,651.11	Facility		$706.01	$1,402.94	$1,651.11
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,005.40 / $1,022.42 / $10,171.53	Facility		$1,005.40	$1,022.42	$10,171.53
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $498.75 / $962.50 / $1,850.37	Professional		$498.75	$962.50	$1,850.37
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $12,805.53 / $19,381.37 / $37,074.37	Facility		$12,805.53	$19,381.37	$37,074.37
Regence BlueShield Facility/Professional Facility Modifier 50 Low / Median / High Price $19,208.30 / $29,072.06 / $55,611.57	Facility	50	$19,208.30	$29,072.06	$55,611.57
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $483.57 / $979.03 / $1,814.56	Professional		$483.57	$979.03	$1,814.56
United Facility/Professional Facility Modifier Low / Median / High Price $3,028.00 / $5,547.00 / $19,271.00	Facility		$3,028.00	$5,547.00	$19,271.00
United Facility/Professional Professional Modifier Low / Median / High Price $918.48 / $1,452.56 / $2,115.80	Professional		$918.48	$1,452.56	$2,115.80
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $319.02 / $591.05 / $805.20	Professional		$319.02	$591.05	$805.20