Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $800.75 / $1,406.88 / $18,711.00	Facility		$800.75	$1,406.88	$18,711.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $6,369.98 / $8,955.00 / $8,955.00	Facility	50	$6,369.98	$8,955.00	$8,955.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $402.43 / $624.82 / $1,226.90	Professional		$402.43	$624.82	$1,226.90
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $78.04 / $780.44 / $2,802.60	Professional	50	$78.04	$780.44	$2,802.60
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 $690.73 / $1,068.43 / $5,606.00	Professional		$690.73	$1,068.43	$5,606.00
Asuris Northwest Health Facility/Professional Professional Modifier 50 Low / Median / High Price $1,045.68 / $1,290.78 / $2,274.00	Professional	50	$1,045.68	$1,290.78	$2,274.00
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 $492.49 / $776.51 / $1,553.65	Professional		$492.49	$776.51	$1,553.65
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $524.82 / $956.07 / $1,802.15	Facility		$524.82	$956.07	$1,802.15
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 $525.22 / $973.27 / $1,399.44	Professional		$525.22	$973.27	$1,399.44
Molina Facility/Professional Professional Modifier Low / Median / High Price $75.97 / $299.09 / $1,010.90	Professional		$75.97	$299.09	$1,010.90
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $675.39 / $933.98 / $1,085.40	Facility		$675.39	$933.98	$1,085.40
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $723.44 / $723.44 / $779.79	Facility		$723.44	$723.44	$779.79
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $700.81 / $1,009.87 / $1,362.38	Professional		$700.81	$1,009.87	$1,362.38
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 $577.96 / $997.05 / $1,374.60	Professional		$577.96	$997.05	$1,374.60
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 $601.70 / $833.34 / $1,447.38	Professional		$601.70	$833.34	$1,447.38