Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $249.03 / $577.84 / $17,930.00	Facility		$249.03	$577.84	$17,930.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $2,282.62 / $2,282.62 / $2,282.62	Facility	50	$2,282.62	$2,282.62	$2,282.62
Aetna Facility/Professional Professional Modifier Low / Median / High Price $123.85 / $216.50 / $501.42	Professional		$123.85	$216.50	$501.42
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $296.33 / $533.70 / $1,486.50	Professional	50	$296.33	$533.70	$1,486.50
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $151.35 / $1,461.50 / $2,982.61	Facility		$151.35	$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 $237.19 / $418.54 / $1,506.00	Professional		$237.19	$418.54	$1,506.00
Asuris Northwest Health Facility/Professional Professional Modifier 50 Low / Median / High Price $186.27 / $352.06 / $390.00	Professional	50	$186.27	$352.06	$390.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $195.45 / $195.45 / $325.61	Facility		$195.45	$195.45	$325.61
Cigna Facility/Professional Professional Modifier Low / Median / High Price $203.92 / $356.54 / $619.00	Professional		$203.92	$356.54	$619.00
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $184.47 / $309.48 / $535.15	Facility		$184.47	$309.48	$535.15
Kaiser Permanente Facility/Professional Facility Modifier 50 Low / Median / High Price $1,683.28 / $1,990.93 / $4,049.97	Facility	50	$1,683.28	$1,990.93	$4,049.97
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $190.44 / $309.48 / $494.86	Professional		$190.44	$309.48	$494.86
Molina Facility/Professional Professional Modifier Low / Median / High Price $43.58 / $276.70 / $476.75	Professional		$43.58	$276.70	$476.75
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $241.92 / $376.54 / $409.37	Facility		$241.92	$376.54	$409.37
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $151.35 / $273.61 / $279.23	Facility		$151.35	$273.61	$279.23
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $239.95 / $337.41 / $511.83	Professional		$239.95	$337.41	$511.83
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 $214.32 / $312.52 / $472.91	Professional		$214.32	$312.52	$472.91
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 $247.28 / $430.82 / $589.91	Professional		$247.28	$430.82	$589.91