Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,025.93 / $5,128.00 / $18,800.00	Facility		$1,025.93	$5,128.00	$18,800.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $6,540.83 / $6,540.83 / $6,540.83	Facility	50	$6,540.83	$6,540.83	$6,540.83
Aetna Facility/Professional Professional Modifier Low / Median / High Price $442.08 / $659.96 / $1,421.95	Professional		$442.08	$659.96	$1,421.95
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 $761.37 / $1,268.52 / $6,211.45	Professional		$761.37	$1,268.52	$6,211.45
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 $559.51 / $889.08 / $1,720.18	Professional		$559.51	$889.08	$1,720.18
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $681.58 / $1,164.86 / $2,131.19	Facility		$681.58	$1,164.86	$2,131.19
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 $681.58 / $1,164.86 / $1,802.15	Professional		$681.58	$1,164.86	$1,802.15
Molina Facility/Professional Professional Modifier Low / Median / High Price $78.13 / $344.64 / $1,098.84	Professional		$78.13	$344.64	$1,098.84
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $773.26 / $1,069.32 / $1,119.57	Facility		$773.26	$1,069.32	$1,119.57
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $732.50 / $732.50 / $759.53	Facility		$732.50	$732.50	$759.53
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $781.80 / $1,250.16 / $1,507.60	Professional		$781.80	$1,250.16	$1,507.60
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 $747.05 / $1,092.59 / $1,439.29	Professional		$747.05	$1,092.59	$1,439.29
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 $642.00 / $840.58 / $1,570.14	Professional		$642.00	$840.58	$1,570.14