Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $992.50 / $2,068.80 / $20,680.40	Facility		$992.50	$2,068.80	$20,680.40
Aetna Facility/Professional Professional Modifier Low / Median / High Price $471.33 / $706.10 / $1,264.86	Professional		$471.33	$706.10	$1,264.86
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $707.01 / $2,018.04 / $2,092.69	Professional	50	$707.01	$2,018.04	$2,092.69
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $1,071.92 / $6,622.22 / $14,645.34	Facility		$1,071.92	$6,622.22	$14,645.34
Asuris Northwest Health Facility/Professional Facility Modifier 50 Low / Median / High Price $7,587.51 / $9,933.33 / $19,217.09	Facility	50	$7,587.51	$9,933.33	$19,217.09
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $911.20 / $1,529.86 / $5,529.44	Professional		$911.20	$1,529.86	$5,529.44
Asuris Northwest Health Facility/Professional Professional Modifier 50 Low / Median / High Price $1,284.63 / $1,613.88 / $2,842.50	Professional	50	$1,284.63	$1,613.88	$2,842.50
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 $572.79 / $1,030.85 / $2,140.23	Professional		$572.79	$1,030.85	$2,140.23
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $666.29 / $1,132.08 / $2,043.57	Facility		$666.29	$1,132.08	$2,043.57
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 $668.92 / $1,154.92 / $1,895.74	Professional		$668.92	$1,154.92	$1,895.74
Molina Facility/Professional Professional Modifier Low / Median / High Price $78.68 / $397.29 / $1,445.36	Professional		$78.68	$397.29	$1,445.36
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $991.29 / $1,370.82 / $1,488.07	Facility		$991.29	$1,370.82	$1,488.07
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $925.25 / $993.88 / $1,015.00	Facility		$925.25	$993.88	$1,015.00
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $874.47 / $1,325.71 / $1,860.53	Professional		$874.47	$1,325.71	$1,860.53
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $4,832.13 / $6,618.43 / $12,667.56	Facility		$4,832.13	$6,618.43	$12,667.56
Regence BlueShield Facility/Professional Facility Modifier 50 Low / Median / High Price $7,248.20 / $9,927.65 / $19,001.34	Facility	50	$7,248.20	$9,927.65	$19,001.34
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $721.18 / $1,285.67 / $1,831.88	Professional		$721.18	$1,285.67	$1,831.88
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 $840.33 / $1,148.40 / $2,101.39	Professional		$840.33	$1,148.40	$2,101.39