Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $516.52 / $2,064.40 / $13,750.00	Facility		$516.52	$2,064.40	$13,750.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $2,535.19 / $2,535.19 / $9,168.10	Facility	50	$2,535.19	$2,535.19	$9,168.10
Aetna Facility/Professional Professional Modifier Low / Median / High Price $453.53 / $923.25 / $1,403.13	Professional		$453.53	$923.25	$1,403.13
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $9,523.17 / $9,523.17 / $9,523.17	Professional	50	$9,523.17	$9,523.17	$9,523.17
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $237.85 / $1,646.32 / $3,151.02	Facility		$237.85	$1,646.32	$3,151.02
Asuris Northwest Health Facility/Professional Facility Modifier 50 Low / Median / High Price $1,816.02 / $2,470.89 / $4,780.18	Facility	50	$1,816.02	$2,470.89	$4,780.18
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $455.99 / $793.18 / $4,749.87	Professional		$455.99	$793.18	$4,749.87
Asuris Northwest Health Facility/Professional Professional Modifier 50 Low / Median / High Price $567.00 / $980.70 / $1,489.50	Professional	50	$567.00	$980.70	$1,489.50
Cigna Facility/Professional Facility Modifier Low / Median / High Price $408.37 / $408.37 / $479.00	Facility		$408.37	$408.37	$479.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $355.10 / $610.47 / $1,225.28	Professional		$355.10	$610.47	$1,225.28
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $208.34 / $791.90 / $2,074.62	Facility		$208.34	$791.90	$2,074.62
Kaiser Permanente Facility/Professional Facility Modifier 50 Low / Median / High Price $1,444.17 / $1,588.70 / $4,299.31	Facility	50	$1,444.17	$1,588.70	$4,299.31
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $209.64 / $768.32 / $1,534.78	Professional		$209.64	$768.32	$1,534.78
Molina Facility/Professional Professional Modifier Low / Median / High Price $37.16 / $270.94 / $695.17	Professional		$37.16	$270.94	$695.17
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $523.15 / $661.32 / $1,852.34	Facility		$523.15	$661.32	$1,852.34
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $237.85 / $447.11 / $462.03	Facility		$237.85	$447.11	$462.03
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $462.03 / $705.32 / $874.97	Professional		$462.03	$705.32	$874.97
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $1,195.59 / $1,646.32 / $3,151.02	Facility		$1,195.59	$1,646.32	$3,151.02
Regence BlueShield Facility/Professional Facility Modifier 50 Low / Median / High Price $1,793.40 / $2,469.48 / $4,726.53	Facility	50	$1,793.40	$2,469.48	$4,726.53
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $405.17 / $644.82 / $921.80	Professional		$405.17	$644.82	$921.80
United Facility/Professional Facility Modifier Low / Median / High Price $332.00 / $648.00 / $4,611.00	Facility		$332.00	$648.00	$4,611.00
United Facility/Professional Professional Modifier Low / Median / High Price $433.79 / $706.51 / $1,408.06	Professional		$433.79	$706.51	$1,408.06