Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $257.86 / $627.77 / $14,464.32	Facility		$257.86	$627.77	$14,464.32
Aetna Facility/Professional Professional Modifier Low / Median / High Price $132.00 / $216.27 / $413.47	Professional		$132.00	$216.27	$413.47
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $1,587.00 / $1,587.00 / $1,587.00	Professional	50	$1,587.00	$1,587.00	$1,587.00
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $172.35 / $1,461.50 / $2,982.61	Facility		$172.35	$1,461.50	$2,982.61
Asuris Northwest Health Facility/Professional Facility Modifier 50 Low / Median / High Price $1,680.87 / $2,338.83 / $4,524.71	Facility	50	$1,680.87	$2,338.83	$4,524.71
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $239.06 / $445.01 / $1,608.96	Professional		$239.06	$445.01	$1,608.96
Asuris Northwest Health Facility/Professional Professional Modifier 50 Low / Median / High Price $190.75 / $336.00 / $529.50	Professional	50	$190.75	$336.00	$529.50
Cigna Facility/Professional Facility Modifier Low / Median / High Price $219.36 / $219.36 / $365.45	Facility		$219.36	$219.36	$365.45
Cigna Facility/Professional Professional Modifier Low / Median / High Price $226.27 / $384.23 / $663.13	Professional		$226.27	$384.23	$663.13
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $191.31 / $326.77 / $585.97	Facility		$191.31	$326.77	$585.97
Kaiser Permanente Facility/Professional Facility Modifier 50 Low / Median / High Price $1,683.28 / $2,230.36 / $4,358.93	Facility	50	$1,683.28	$2,230.36	$4,358.93
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $196.04 / $325.95 / $534.29	Professional		$196.04	$325.95	$534.29
Molina Facility/Professional Professional Modifier Low / Median / High Price $47.76 / $301.43 / $513.88	Professional		$47.76	$301.43	$513.88
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $240.20 / $403.34 / $437.51	Facility		$240.20	$403.34	$437.51
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $172.35 / $294.45 / $298.42	Facility		$172.35	$294.45	$298.42
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $247.12 / $354.86 / $547.02	Professional		$247.12	$354.86	$547.02
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $1,120.58 / $1,549.85 / $2,982.61	Facility		$1,120.58	$1,549.85	$2,982.61
Regence BlueShield Facility/Professional Facility Modifier 50 Low / Median / High Price $1,680.87 / $2,324.78 / $4,473.92	Facility	50	$1,680.87	$2,324.78	$4,473.92
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $221.32 / $334.01 / $505.42	Professional		$221.32	$334.01	$505.42
United Facility/Professional Facility Modifier Low / Median / High Price $190.00 / $666.00 / $6,216.00	Facility		$190.00	$666.00	$6,216.00
United Facility/Professional Professional Modifier Low / Median / High Price $264.88 / $461.13 / $663.48	Professional		$264.88	$461.13	$663.48