Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $253.13 / $715.81 / $17,100.00	Facility		$253.13	$715.81	$17,100.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $2,180.25 / $2,180.25 / $2,180.25	Facility	50	$2,180.25	$2,180.25	$2,180.25
Aetna Facility/Professional Professional Modifier Low / Median / High Price $128.18 / $254.51 / $634.42	Professional		$128.18	$254.51	$634.42
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $444.17 / $2,867.49 / $7,423.29	Facility		$444.17	$2,867.49	$7,423.29
Asuris Northwest Health Facility/Professional Facility Modifier 50 Low / Median / High Price $2,954.69 / $4,303.70 / $8,325.95	Facility	50	$2,954.69	$4,303.70	$8,325.95
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $250.27 / $552.11 / $2,319.23	Professional		$250.27	$552.11	$2,319.23
Asuris Northwest Health Facility/Professional Professional Modifier 50 Low / Median / High Price $328.35 / $412.32 / $791.97	Professional	50	$328.35	$412.32	$791.97
Cigna Facility/Professional Facility Modifier Low / Median / High Price $642.00 / $642.00 / $1,174.76	Facility		$642.00	$642.00	$1,174.76
Cigna Facility/Professional Professional Modifier Low / Median / High Price $161.88 / $342.12 / $720.37	Professional		$161.88	$342.12	$720.37
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $173.92 / $372.88 / $827.06	Facility		$173.92	$372.88	$827.06
Kaiser Permanente Facility/Professional Facility Modifier 50 Low / Median / High Price $2,374.37 / $2,611.98 / $7,087.32	Facility	50	$2,374.37	$2,611.98	$7,087.32
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $175.18 / $372.88 / $742.66	Professional		$175.18	$372.88	$742.66
Molina Facility/Professional Professional Modifier Low / Median / High Price $44.92 / $275.43 / $595.11	Professional		$44.92	$275.43	$595.11
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $261.97 / $494.46 / $540.02	Facility		$261.97	$494.46	$540.02
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $365.12 / $365.12 / $376.63	Facility		$365.12	$365.12	$376.63
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $224.25 / $371.00 / $678.15	Professional		$224.25	$371.00	$678.15
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $1,860.50 / $2,805.46 / $5,488.32	Facility		$1,860.50	$2,805.46	$5,488.32
Regence BlueShield Facility/Professional Facility Modifier 50 Low / Median / High Price $2,790.75 / $4,208.18 / $8,232.48	Facility	50	$2,790.75	$4,208.18	$8,232.48
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $182.49 / $372.37 / $670.64	Professional		$182.49	$372.37	$670.64
United Facility/Professional Facility Modifier Low / Median / High Price $500.00 / $1,050.00 / $6,857.00	Facility		$500.00	$1,050.00	$6,857.00
United Facility/Professional Professional Modifier Low / Median / High Price $315.69 / $419.09 / $754.37	Professional		$315.69	$419.09	$754.37