Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $865.72 / $1,492.24 / $18,711.00	Facility		$865.72	$1,492.24	$18,711.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $413.49 / $547.16 / $1,337.51	Professional		$413.49	$547.16	$1,337.51
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $925.25 / $6,622.22 / $14,645.34	Facility		$925.25	$6,622.22	$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 $775.24 / $1,269.94 / $4,495.07	Professional		$775.24	$1,269.94	$4,495.07
Cigna Facility/Professional Facility Modifier Low / Median / High Price $734.00 / $734.00 / $2,430.19	Facility		$734.00	$734.00	$2,430.19
Cigna Facility/Professional Professional Modifier Low / Median / High Price $534.15 / $844.33 / $1,630.22	Professional		$534.15	$844.33	$1,630.22
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $578.24 / $1,045.20 / $1,808.43	Facility		$578.24	$1,045.20	$1,808.43
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 $583.76 / $1,054.33 / $1,536.34	Professional		$583.76	$1,054.33	$1,536.34
Molina Facility/Professional Professional Modifier Low / Median / High Price $77.42 / $301.76 / $1,080.99	Professional		$77.42	$301.76	$1,080.99
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $772.29 / $1,057.81 / $1,144.35	Facility		$772.29	$1,057.81	$1,144.35
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $760.13 / $760.13 / $780.56	Facility		$760.13	$760.13	$780.56
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $761.87 / $1,096.36 / $1,465.30	Professional		$761.87	$1,096.36	$1,465.30
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 $628.32 / $1,069.05 / $1,451.47	Professional		$628.32	$1,069.05	$1,451.47
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 $658.92 / $869.40 / $1,591.08	Professional		$658.92	$869.40	$1,591.08