Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $842.41 / $1,733.00 / $18,711.00	Facility		$842.41	$1,733.00	$18,711.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $9,357.43 / $9,357.43 / $9,357.43	Facility	50	$9,357.43	$9,357.43	$9,357.43
Aetna Facility/Professional Professional Modifier Low / Median / High Price $393.81 / $608.61 / $1,402.60	Professional		$393.81	$608.61	$1,402.60
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $4,007.74 / $4,007.74 / $4,007.74	Professional	50	$4,007.74	$4,007.74	$4,007.74
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 $771.17 / $1,314.22 / $4,830.56	Professional		$771.17	$1,314.22	$4,830.56
Asuris Northwest Health Facility/Professional Professional Modifier 50 Low / Median / High Price $1,250.22 / $1,909.70 / $2,397.00	Professional	50	$1,250.22	$1,909.70	$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 $526.50 / $868.68 / $1,867.02	Professional		$526.50	$868.68	$1,867.02
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $560.79 / $1,045.20 / $1,835.17	Facility		$560.79	$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 $562.96 / $1,054.33 / $1,682.41	Professional		$562.96	$1,054.33	$1,682.41
Molina Facility/Professional Professional Modifier Low / Median / High Price $78.81 / $372.53 / $1,263.15	Professional		$78.81	$372.53	$1,263.15
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $802.99 / $1,187.20 / $1,299.80	Facility		$802.99	$1,187.20	$1,299.80
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $872.03 / $872.03 / $886.58	Facility		$872.03	$872.03	$886.58
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $742.51 / $1,135.65 / $1,625.14	Professional		$742.51	$1,135.65	$1,625.14
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 $608.91 / $1,087.24 / $1,600.11	Professional		$608.91	$1,087.24	$1,600.11
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 $712.53 / $968.32 / $1,808.74	Professional		$712.53	$968.32	$1,808.74