Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $932.51 / $1,692.26 / $18,711.00	Facility		$932.51	$1,692.26	$18,711.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $6,320.00 / $13,389.97 / $19,336.93	Facility	50	$6,320.00	$13,389.97	$19,336.93
Aetna Facility/Professional Professional Modifier Low / Median / High Price $446.22 / $760.25 / $1,925.36	Professional		$446.22	$760.25	$1,925.36
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $406.75 / $1,232.98 / $2,975.00	Professional	50	$406.75	$1,232.98	$2,975.00
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $1,071.92 / $6,622.22 / $14,645.34	Facility		$1,071.92	$6,622.22	$14,645.34
Asuris Northwest Health Facility/Professional Facility Modifier 50 Low / Median / High Price $7,587.51 / $9,933.33 / $19,217.09	Facility	50	$7,587.51	$9,933.33	$19,217.09
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $867.31 / $1,400.65 / $4,849.92	Professional		$867.31	$1,400.65	$4,849.92
Asuris Northwest Health Facility/Professional Professional Modifier 50 Low / Median / High Price $1,372.63 / $1,545.08 / $2,655.00	Professional	50	$1,372.63	$1,545.08	$2,655.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $906.00 / $906.00 / $2,430.19	Facility		$906.00	$906.00	$2,430.19
Cigna Facility/Professional Professional Modifier Low / Median / High Price $558.35 / $951.84 / $1,856.74	Professional		$558.35	$951.84	$1,856.74
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $621.59 / $1,064.68 / $1,835.17	Facility		$621.59	$1,064.68	$1,835.17
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 $622.04 / $1,112.74 / $1,675.55	Professional		$622.04	$1,112.74	$1,675.55
Molina Facility/Professional Professional Modifier Low / Median / High Price $77.42 / $335.89 / $1,259.89	Professional		$77.42	$335.89	$1,259.89
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $782.65 / $1,200.33 / $1,304.49	Facility		$782.65	$1,200.33	$1,304.49
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $866.14 / $866.14 / $925.25	Facility		$866.14	$866.14	$925.25
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $820.13 / $1,179.64 / $1,669.39	Professional		$820.13	$1,179.64	$1,669.39
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $4,832.13 / $6,618.43 / $12,667.56	Facility		$4,832.13	$6,618.43	$12,667.56
Regence BlueShield Facility/Professional Facility Modifier 50 Low / Median / High Price $7,248.20 / $9,927.65 / $19,001.34	Facility	50	$7,248.20	$9,927.65	$19,001.34
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $676.37 / $1,171.49 / $1,608.64	Professional		$676.37	$1,171.49	$1,608.64
United Facility/Professional Facility Modifier Low / Median / High Price $1,415.00 / $8,178.12 / $13,346.42	Facility		$1,415.00	$8,178.12	$13,346.42
United Facility/Professional Professional Modifier Low / Median / High Price $748.50 / $966.79 / $1,808.50	Professional		$748.50	$966.79	$1,808.50