Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $789.30 / $1,576.40 / $18,711.00	Facility		$789.30	$1,576.40	$18,711.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $399.93 / $660.71 / $1,537.41	Professional		$399.93	$660.71	$1,537.41
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 $740.01 / $1,290.16 / $4,946.76	Professional		$740.01	$1,290.16	$4,946.76
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 $496.00 / $819.97 / $1,754.80	Professional		$496.00	$819.97	$1,754.80
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $529.20 / $1,020.30 / $1,835.17	Facility		$529.20	$1,020.30	$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 $537.91 / $1,020.30 / $1,581.23	Professional		$537.91	$1,020.30	$1,581.23
Molina Facility/Professional Professional Modifier Low / Median / High Price $76.04 / $312.37 / $1,147.26	Professional		$76.04	$312.37	$1,147.26
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $748.71 / $1,113.83 / $1,220.74	Facility		$748.71	$1,113.83	$1,220.74
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $819.93 / $819.93 / $832.65	Facility		$819.93	$819.93	$832.65
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $699.32 / $1,070.33 / $1,528.82	Professional		$699.32	$1,070.33	$1,528.82
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 $573.79 / $1,024.41 / $1,509.77	Professional		$573.79	$1,024.41	$1,509.77
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 $664.08 / $970.40 / $1,698.85	Professional		$664.08	$970.40	$1,698.85