Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,663.51 / $7,858.37 / $20,680.40	Facility		$1,663.51	$7,858.37	$20,680.40
Aetna Facility/Professional Professional Modifier Low / Median / High Price $702.84 / $986.25 / $2,085.14	Professional		$702.84	$986.25	$2,085.14
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $1,349.06 / $6,763.39 / $14,645.34	Facility		$1,349.06	$6,763.39	$14,645.34
Asuris Northwest Health Facility/Professional Facility Modifier 50 Low / Median / High Price $6,634.41 / $9,933.33 / $19,217.09	Facility	50	$6,634.41	$9,933.33	$19,217.09
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $1,363.82 / $2,349.77 / $8,438.70	Professional		$1,363.82	$2,349.77	$8,438.70
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,031.00 / $1,031.00 / $2,430.19	Facility		$1,031.00	$1,031.00	$2,430.19
Cigna Facility/Professional Professional Modifier Low / Median / High Price $913.28 / $1,472.04 / $3,112.62	Professional		$913.28	$1,472.04	$3,112.62
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,041.00 / $1,290.70 / $2,536.19	Facility		$1,041.00	$1,290.70	$2,536.19
Kaiser Permanente Facility/Professional Facility Modifier 50 Low / Median / High Price $5,752.58 / $6,328.28 / $15,568.54	Facility	50	$5,752.58	$6,328.28	$15,568.54
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,041.00 / $1,291.29 / $2,536.19	Professional		$1,041.00	$1,291.29	$2,536.19
Molina Facility/Professional Professional Modifier Low / Median / High Price $116.38 / $576.80 / $1,918.38	Professional		$116.38	$576.80	$1,918.38
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,206.86 / $1,682.64 / $1,977.84	Facility		$1,206.86	$1,682.64	$1,977.84
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $925.25 / $1,337.26 / $1,349.06	Facility		$925.25	$1,337.26	$1,349.06
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,402.20 / $2,230.69 / $2,692.03	Professional		$1,402.20	$2,230.69	$2,692.03
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $4,294.21 / $6,618.43 / $12,667.56	Facility		$4,294.21	$6,618.43	$12,667.56
Regence BlueShield Facility/Professional Facility Modifier 50 Low / Median / High Price $6,441.32 / $9,927.65 / $19,001.34	Facility	50	$6,441.32	$9,927.65	$19,001.34
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $1,363.82 / $1,940.64 / $2,553.48	Professional		$1,363.82	$1,940.64	$2,553.48
United Facility/Professional Facility Modifier Low / Median / High Price $1,224.00 / $1,862.00 / $10,522.00	Facility		$1,224.00	$1,862.00	$10,522.00
United Facility/Professional Professional Modifier Low / Median / High Price $1,044.40 / $1,357.72 / $2,590.06	Professional		$1,044.40	$1,357.72	$2,590.06