Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,733.00 / $6,470.00 / $18,711.00	Facility		$1,733.00	$6,470.00	$18,711.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $765.90 / $982.09 / $2,214.26	Professional		$765.90	$982.09	$2,214.26
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $1,241.33 / $2,366.21 / $6,841.86	Professional	50	$1,241.33	$2,366.21	$6,841.86
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $1,462.03 / $10,956.90 / $24,231.69	Facility		$1,462.03	$10,956.90	$24,231.69
Asuris Northwest Health Facility/Professional Facility Modifier 50 Low / Median / High Price $10,889.49 / $16,435.34 / $31,795.95	Facility	50	$10,889.49	$16,435.34	$31,795.95
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $1,430.98 / $2,563.04 / $8,835.53	Professional		$1,430.98	$2,563.04	$8,835.53
Asuris Northwest Health Facility/Professional Professional Modifier 50 Low / Median / High Price $1,993.51 / $2,961.45 / $4,558.50	Professional	50	$1,993.51	$2,961.45	$4,558.50
Cigna Facility/Professional Facility Modifier Low / Median / High Price $734.00 / $734.00 / $3,759.09	Facility		$734.00	$734.00	$3,759.09
Cigna Facility/Professional Professional Modifier Low / Median / High Price $958.42 / $1,608.61 / $3,255.47	Professional		$958.42	$1,608.61	$3,255.47
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,128.05 / $1,863.78 / $3,376.68	Facility		$1,128.05	$1,863.78	$3,376.68
Kaiser Permanente Facility/Professional Facility Modifier 50 Low / Median / High Price $9,510.91 / $10,462.73 / $25,389.69	Facility	50	$9,510.91	$10,462.73	$25,389.69
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,128.05 / $1,863.78 / $3,285.00	Professional		$1,128.05	$1,863.78	$3,285.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $116.13 / $598.18 / $2,015.32	Professional		$116.13	$598.18	$2,015.32
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,314.66 / $1,838.48 / $2,072.98	Facility		$1,314.66	$1,838.48	$2,072.98
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,389.35 / $1,389.35 / $1,413.96	Facility		$1,389.35	$1,389.35	$1,413.96
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,456.83 / $2,341.36 / $2,812.24	Professional		$1,456.83	$2,341.36	$2,812.24
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $7,105.06 / $10,950.64 / $20,959.32	Facility		$7,105.06	$10,950.64	$20,959.32
Regence BlueShield Facility/Professional Facility Modifier 50 Low / Median / High Price $10,657.59 / $16,425.96 / $31,438.98	Facility	50	$10,657.59	$16,425.96	$31,438.98
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $1,416.95 / $2,044.56 / $2,679.40	Professional		$1,416.95	$2,044.56	$2,679.40
United Facility/Professional Facility Modifier Low / Median / High Price $1,771.00 / $13,013.21 / $21,573.23	Facility		$1,771.00	$13,013.21	$21,573.23
United Facility/Professional Professional Modifier Low / Median / High Price $1,114.80 / $1,449.25 / $2,759.14	Professional		$1,114.80	$1,449.25	$2,759.14