Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $849.52 / $1,515.36 / $17,930.00	Facility		$849.52	$1,515.36	$17,930.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $408.02 / $613.86 / $1,202.76	Professional		$408.02	$613.86	$1,202.76
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $481.90 / $481.90 / $1,104.56	Professional	50	$481.90	$481.90	$1,104.56
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 $744.47 / $1,195.52 / $4,805.00	Professional		$744.47	$1,195.52	$4,805.00
Asuris Northwest Health Facility/Professional Professional Modifier 50 Low / Median / High Price $1,236.38 / $1,380.89 / $2,430.00	Professional	50	$1,236.38	$1,380.89	$2,430.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $642.00 / $642.00 / $2,430.19	Facility		$642.00	$642.00	$2,430.19
Cigna Facility/Professional Professional Modifier Low / Median / High Price $543.14 / $855.75 / $1,671.06	Professional		$543.14	$855.75	$1,671.06
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $567.42 / $1,038.46 / $1,835.17	Facility		$567.42	$1,038.46	$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 $567.86 / $1,041.79 / $1,536.34	Professional		$567.86	$1,041.79	$1,536.34
Molina Facility/Professional Professional Modifier Low / Median / High Price $76.76 / $315.23 / $1,162.01	Professional		$76.76	$315.23	$1,162.01
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $710.74 / $1,076.84 / $1,171.83	Facility		$710.74	$1,076.84	$1,171.83
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $781.43 / $781.43 / $799.29	Facility		$781.43	$781.43	$799.29
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $750.11 / $1,079.68 / $1,503.67	Professional		$750.11	$1,079.68	$1,503.67
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 $618.62 / $1,068.27 / $1,492.13	Professional		$618.62	$1,068.27	$1,492.13
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 $687.99 / $902.33 / $1,623.69	Professional		$687.99	$902.33	$1,623.69