Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $833.64 / $1,523.58 / $18,711.00	Facility		$833.64	$1,523.58	$18,711.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $400.26 / $548.16 / $1,107.83	Professional		$400.26	$548.16	$1,107.83
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $1,025.33 / $1,025.33 / $1,025.33	Professional	50	$1,025.33	$1,025.33	$1,025.33
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 $732.00 / $1,174.64 / $4,405.00	Professional		$732.00	$1,174.64	$4,405.00
Asuris Northwest Health Facility/Professional Professional Modifier 50 Low / Median / High Price $1,232.00 / $1,359.03 / $2,386.50	Professional	50	$1,232.00	$1,359.03	$2,386.50
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 $523.87 / $857.22 / $1,685.36	Professional		$523.87	$857.22	$1,685.36
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $559.07 / $1,041.79 / $1,835.17	Facility		$559.07	$1,041.79	$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 $559.49 / $1,044.58 / $1,536.34	Professional		$559.49	$1,044.58	$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 $781.44 / $1,088.08 / $1,179.20	Facility		$781.44	$1,088.08	$1,179.20
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $783.69 / $783.69 / $804.32	Facility		$783.69	$783.69	$804.32
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $734.98 / $1,058.26 / $1,501.07	Professional		$734.98	$1,058.26	$1,501.07
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 $606.14 / $1,048.28 / $1,496.45	Professional		$606.14	$1,048.28	$1,496.45
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 $683.28 / $873.98 / $1,593.66	Professional		$683.28	$873.98	$1,593.66