Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $838.14 / $1,719.99 / $18,711.00	Facility		$838.14	$1,719.99	$18,711.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $6,540.83 / $6,540.83 / $6,697.80	Facility	50	$6,540.83	$6,540.83	$6,697.80
Aetna Facility/Professional Professional Modifier Low / Median / High Price $416.93 / $571.33 / $1,189.11	Professional		$416.93	$571.33	$1,189.11
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $210.69 / $210.69 / $210.69	Professional	50	$210.69	$210.69	$210.69
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 $783.01 / $1,288.81 / $4,642.80	Professional		$783.01	$1,288.81	$4,642.80
Asuris Northwest Health Facility/Professional Professional Modifier 50 Low / Median / High Price $1,257.09 / $1,471.58 / $2,397.00	Professional	50	$1,257.09	$1,471.58	$2,397.00
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 $534.76 / $861.61 / $1,789.58	Professional		$534.76	$861.61	$1,789.58
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $583.76 / $1,045.20 / $1,835.17	Facility		$583.76	$1,045.20	$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 $584.20 / $1,054.33 / $1,615.53	Professional		$584.20	$1,054.33	$1,615.53
Molina Facility/Professional Professional Modifier Low / Median / High Price $77.42 / $314.07 / $1,219.01	Professional		$77.42	$314.07	$1,219.01
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $801.81 / $1,141.01 / $1,248.88	Facility		$801.81	$1,141.01	$1,248.88
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $837.60 / $837.60 / $851.85	Facility		$837.60	$837.60	$851.85
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $739.46 / $1,112.61 / $1,561.47	Professional		$739.46	$1,112.61	$1,561.47
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 $609.84 / $1,087.24 / $1,541.99	Professional		$609.84	$1,087.24	$1,541.99
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 $699.21 / $992.77 / $1,732.50	Professional		$699.21	$992.77	$1,732.50