Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $988.00 / $6,470.00 / $21,917.86	Facility		$988.00	$6,470.00	$21,917.86
Aetna Facility/Professional Professional Modifier Low / Median / High Price $566.33 / $971.70 / $1,850.30	Professional		$566.33	$971.70	$1,850.30
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $1,462.03 / $10,956.90 / $24,231.69	Facility		$1,462.03	$10,956.90	$24,231.69
Asuris Northwest Health Facility/Professional Facility Modifier 50 Low / Median / High Price $10,889.49 / $16,435.34 / $31,795.95	Facility	50	$10,889.49	$16,435.34	$31,795.95
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $902.70 / $1,581.15 / $5,456.03	Professional		$902.70	$1,581.15	$5,456.03
Cigna Facility/Professional Facility Modifier Low / Median / High Price $906.00 / $906.00 / $3,759.09	Facility		$906.00	$906.00	$3,759.09
Cigna Facility/Professional Professional Modifier Low / Median / High Price $645.88 / $1,024.79 / $1,990.64	Professional		$645.88	$1,024.79	$1,990.64
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $786.83 / $1,580.72 / $3,376.68	Facility		$786.83	$1,580.72	$3,376.68
Kaiser Permanente Facility/Professional Facility Modifier 50 Low / Median / High Price $9,510.91 / $10,462.73 / $25,389.69	Facility	50	$9,510.91	$10,462.73	$25,389.69
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $786.83 / $1,545.69 / $2,787.60	Professional		$786.83	$1,545.69	$2,787.60
Molina Facility/Professional Professional Modifier Low / Median / High Price $78.68 / $373.65 / $1,254.90	Professional		$78.68	$373.65	$1,254.90
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $891.00 / $1,232.13 / $1,295.10	Facility		$891.00	$1,232.13	$1,295.10
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $844.85 / $844.85 / $1,071.92	Facility		$844.85	$844.85	$1,071.92
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $902.70 / $1,443.43 / $1,740.72	Professional		$902.70	$1,443.43	$1,740.72
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $7,105.06 / $10,950.64 / $20,959.32	Facility		$7,105.06	$10,950.64	$20,959.32
Regence BlueShield Facility/Professional Facility Modifier 50 Low / Median / High Price $10,657.59 / $16,425.96 / $31,438.98	Facility	50	$10,657.59	$16,425.96	$31,438.98
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $861.63 / $1,261.55 / $1,699.27	Professional		$861.63	$1,261.55	$1,699.27
United Facility/Professional Facility Modifier Low / Median / High Price $1,620.00 / $2,155.00 / $11,941.00	Facility		$1,620.00	$2,155.00	$11,941.00
United Facility/Professional Professional Modifier Low / Median / High Price $757.35 / $1,003.94 / $1,809.72	Professional		$757.35	$1,003.94	$1,809.72