Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,098.24 / $2,088.36 / $17,967.00	Facility		$1,098.24	$2,088.36	$17,967.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $4,360.50 / $9,781.70 / $13,702.00	Facility	50	$4,360.50	$9,781.70	$13,702.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $519.99 / $708.87 / $1,550.18	Professional		$519.99	$708.87	$1,550.18
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $787.82 / $981.92 / $1,070.82	Professional	50	$787.82	$981.92	$1,070.82
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $1,010.88 / $6,622.22 / $14,645.34	Facility		$1,010.88	$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 $942.70 / $1,458.63 / $7,208.00	Professional		$942.70	$1,458.63	$7,208.00
Asuris Northwest Health Facility/Professional Professional Modifier 50 Low / Median / High Price $1,552.71 / $1,779.35 / $3,129.00	Professional	50	$1,552.71	$1,779.35	$3,129.00
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 $658.12 / $1,094.54 / $2,106.94	Professional		$658.12	$1,094.54	$2,106.94
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $734.67 / $1,134.14 / $2,043.70	Facility		$734.67	$1,134.14	$2,043.70
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 $735.20 / $1,164.03 / $1,893.27	Professional		$735.20	$1,164.03	$1,893.27
Molina Facility/Professional Professional Modifier Low / Median / High Price $78.85 / $452.25 / $1,444.78	Professional		$78.85	$452.25	$1,444.78
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $985.53 / $1,363.49 / $1,482.04	Facility		$985.53	$1,363.49	$1,482.04
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $925.25 / $986.63 / $1,010.88	Facility		$925.25	$986.63	$1,010.88
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $964.66 / $1,385.30 / $1,902.27	Professional		$964.66	$1,385.30	$1,902.27
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 $795.56 / $1,323.56 / $1,826.00	Professional		$795.56	$1,323.56	$1,826.00
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 $862.92 / $1,192.43 / $2,008.31	Professional		$862.92	$1,192.43	$2,008.31