Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $885.72 / $1,692.01 / $18,711.00	Facility		$885.72	$1,692.01	$18,711.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $2,308.50 / $2,308.50 / $6,164.86	Facility	50	$2,308.50	$2,308.50	$6,164.86
Aetna Facility/Professional Professional Modifier Low / Median / High Price $428.62 / $585.97 / $1,176.30	Professional		$428.62	$585.97	$1,176.30
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $1,141.71 / $1,181.43 / $1,492.96	Professional	50	$1,141.71	$1,181.43	$1,492.96
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 $765.61 / $1,193.47 / $7,569.00	Professional		$765.61	$1,193.47	$7,569.00
Asuris Northwest Health Facility/Professional Professional Modifier 50 Low / Median / High Price $1,318.87 / $1,437.90 / $2,521.50	Professional	50	$1,318.87	$1,437.90	$2,521.50
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 $558.29 / $895.91 / $1,718.21	Professional		$558.29	$895.91	$1,718.21
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $600.50 / $1,055.35 / $1,835.17	Facility		$600.50	$1,055.35	$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 $600.86 / $1,057.64 / $1,553.79	Professional		$600.86	$1,057.64	$1,553.79
Molina Facility/Professional Professional Modifier Low / Median / High Price $77.42 / $337.19 / $1,204.26	Professional		$77.42	$337.19	$1,204.26
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $812.99 / $1,124.26 / $1,208.01	Facility		$812.99	$1,124.26	$1,208.01
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $804.98 / $804.98 / $823.97	Facility		$804.98	$804.98	$823.97
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $779.24 / $1,119.34 / $1,549.03	Professional		$779.24	$1,119.34	$1,549.03
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 $642.64 / $1,107.29 / $1,517.51	Professional		$642.64	$1,107.29	$1,517.51
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 $731.00 / $985.60 / $1,633.77	Professional		$731.00	$985.60	$1,633.77