Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $199.71 / $506.42 / $13,750.00	Facility		$199.71	$506.42	$13,750.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $1,328.94 / $1,328.94 / $2,906.82	Facility	50	$1,328.94	$1,328.94	$2,906.82
Aetna Facility/Professional Professional Modifier Low / Median / High Price $108.52 / $199.71 / $461.92	Professional		$108.52	$199.71	$461.92
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $273.74 / $584.00 / $584.00	Professional	50	$273.74	$584.00	$584.00
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $202.66 / $1,824.43 / $3,748.81	Facility		$202.66	$1,824.43	$3,748.81
Asuris Northwest Health Facility/Professional Facility Modifier 50 Low / Median / High Price $1,622.22 / $2,939.66 / $5,687.07	Facility	50	$1,622.22	$2,939.66	$5,687.07
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $187.09 / $309.83 / $1,310.76	Professional		$187.09	$309.83	$1,310.76
Asuris Northwest Health Facility/Professional Professional Modifier 50 Low / Median / High Price $324.36 / $325.50 / $630.00	Professional	50	$324.36	$325.50	$630.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $203.80 / $765.00 / $870.49	Facility		$203.80	$765.00	$870.49
Cigna Facility/Professional Professional Modifier Low / Median / High Price $139.11 / $249.65 / $458.06	Professional		$139.11	$249.65	$458.06
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $129.60 / $242.96 / $440.17	Facility		$129.60	$242.96	$440.17
Kaiser Permanente Facility/Professional Facility Modifier 50 Low / Median / High Price $1,292.06 / $1,928.84 / $4,640.79	Facility	50	$1,292.06	$1,928.84	$4,640.79
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $129.60 / $238.77 / $415.38	Professional		$129.60	$238.77	$415.38
Molina Facility/Professional Professional Modifier Low / Median / High Price $40.99 / $229.20 / $409.35	Professional		$40.99	$229.20	$409.35
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $195.77 / $312.06 / $347.19	Facility		$195.77	$312.06	$347.19
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $67.48 / $219.25 / $222.56	Facility		$67.48	$219.25	$222.56
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $179.93 / $269.22 / $407.58	Professional		$179.93	$269.22	$407.58
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $1,222.18 / $1,916.28 / $3,748.81	Facility		$1,222.18	$1,916.28	$3,748.81
Regence BlueShield Facility/Professional Facility Modifier 50 Low / Median / High Price $1,833.27 / $2,874.42 / $5,623.22	Facility	50	$1,833.27	$2,874.42	$5,623.22
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $173.91 / $260.44 / $384.10	Professional		$173.91	$260.44	$384.10
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 $199.08 / $286.20 / $464.55	Professional		$199.08	$286.20	$464.55
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $114.45 / $133.62 / $176.80	Professional		$114.45	$133.62	$176.80