Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $490.07 / $4,011.00 / $12,306.79	Facility		$490.07	$4,011.00	$12,306.79
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $5,557.44 / $12,868.58 / $12,868.58	Facility	50	$5,557.44	$12,868.58	$12,868.58
Aetna Facility/Professional Professional Modifier Low / Median / High Price $211.86 / $368.72 / $779.41	Professional		$211.86	$368.72	$779.41
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $114.04 / $114.04 / $1,958.02	Professional	50	$114.04	$114.04	$1,958.02
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 $402.23 / $793.78 / $3,222.08	Professional		$402.23	$793.78	$3,222.08
Asuris Northwest Health Facility/Professional Professional Modifier 50 Low / Median / High Price $528.87 / $1,091.15 / $1,649.75	Professional	50	$528.87	$1,091.15	$1,649.75
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 $263.80 / $508.62 / $1,002.23	Professional		$263.80	$508.62	$1,002.23
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $315.77 / $612.91 / $1,802.15	Facility		$315.77	$612.91	$1,802.15
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 $316.01 / $610.61 / $1,255.54	Professional		$316.01	$610.61	$1,255.54
Molina Facility/Professional Professional Modifier Low / Median / High Price $45.89 / $366.84 / $794.11	Professional		$45.89	$366.84	$794.11
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $439.55 / $723.07 / $849.75	Facility		$439.55	$723.07	$849.75
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $508.27 / $508.27 / $730.50	Facility		$508.27	$508.27	$730.50
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $362.12 / $566.78 / $943.37	Professional		$362.12	$566.78	$943.37
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 $296.60 / $542.82 / $952.47	Professional		$296.60	$542.82	$952.47
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 $463.68 / $607.20 / $1,075.23	Professional		$463.68	$607.20	$1,075.23