Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $356.43 / $5,215.97 / $18,711.00	Facility		$356.43	$5,215.97	$18,711.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $197.90 / $442.00 / $816.19	Professional		$197.90	$442.00	$816.19
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $482.32 / $482.32 / $482.32	Professional	50	$482.32	$482.32	$482.32
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $1,374.36 / $5,143.05 / $10,466.57	Facility		$1,374.36	$5,143.05	$10,466.57
Asuris Northwest Health Facility/Professional Facility Modifier 50 Low / Median / High Price $6,292.82 / $8,207.42 / $15,878.12	Facility	50	$6,292.82	$8,207.42	$15,878.12
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $353.65 / $868.29 / $1,653.68	Professional		$353.65	$868.29	$1,653.68
Asuris Northwest Health Facility/Professional Professional Modifier 50 Low / Median / High Price $576.62 / $813.06 / $1,340.88	Professional	50	$576.62	$813.06	$1,340.88
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,190.81 / $2,190.81 / $2,190.81	Facility		$2,190.81	$2,190.81	$2,190.81
Cigna Facility/Professional Professional Modifier Low / Median / High Price $296.20 / $615.55 / $1,407.56	Professional		$296.20	$615.55	$1,407.56
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $294.95 / $710.50 / $1,793.31	Facility		$294.95	$710.50	$1,793.31
Kaiser Permanente Facility/Professional Facility Modifier 50 Low / Median / High Price $4,890.87 / $8,663.79 / $15,732.05	Facility	50	$4,890.87	$8,663.79	$15,732.05
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $294.95 / $595.03 / $1,432.02	Professional		$294.95	$595.03	$1,432.02
Molina Facility/Professional Professional Modifier Low / Median / High Price $47.67 / $513.46 / $1,012.68	Professional		$47.67	$513.46	$1,012.68
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $391.28 / $917.82 / $988.80	Facility		$391.28	$917.82	$988.80
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $648.48 / $648.48 / $648.70	Facility		$648.48	$648.48	$648.70
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $348.59 / $648.48 / $1,185.93	Professional		$348.59	$648.48	$1,185.93
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $3,992.55 / $5,471.61 / $10,466.57	Facility		$3,992.55	$5,471.61	$10,466.57
Regence BlueShield Facility/Professional Facility Modifier 50 Low / Median / High Price $5,988.83 / $8,207.42 / $15,699.86	Facility	50	$5,988.83	$8,207.42	$15,699.86
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $358.28 / $628.51 / $1,077.73	Professional		$358.28	$628.51	$1,077.73
United Facility/Professional Facility Modifier Low / Median / High Price $1,862.00 / $4,818.00 / $11,261.00	Facility		$1,862.00	$4,818.00	$11,261.00
United Facility/Professional Professional Modifier Low / Median / High Price $507.96 / $820.12 / $1,364.26	Professional		$507.96	$820.12	$1,364.26
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $209.50 / $209.50 / $527.57	Professional		$209.50	$209.50	$527.57