Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $208.91 / $6,394.57 / $13,409.00	Facility		$208.91	$6,394.57	$13,409.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $968.31 / $5,763.53 / $9,897.16	Facility	50	$968.31	$5,763.53	$9,897.16
Aetna Facility/Professional Professional Modifier Low / Median / High Price $137.74 / $208.91 / $477.00	Professional		$137.74	$208.91	$477.00
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $156.09 / $475.66 / $3,657.60	Professional	50	$156.09	$475.66	$3,657.60
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $2,633.02 / $4,321.81 / $11,500.00	Facility		$2,633.02	$4,321.81	$11,500.00
Asuris Northwest Health Facility/Professional Facility Modifier 50 Low / Median / High Price $4,951.77 / $6,482.72 / $12,541.50	Facility	50	$4,951.77	$6,482.72	$12,541.50
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $227.67 / $375.83 / $1,429.86	Professional		$227.67	$375.83	$1,429.86
Asuris Northwest Health Facility/Professional Professional Modifier 50 Low / Median / High Price $224.03 / $465.66 / $469.50	Professional	50	$224.03	$465.66	$469.50
Cigna Facility/Professional Facility Modifier Low / Median / High Price $934.63 / $934.63 / $1,557.08	Facility		$934.63	$934.63	$1,557.08
Cigna Facility/Professional Professional Modifier Low / Median / High Price $201.32 / $335.84 / $492.93	Professional		$201.32	$335.84	$492.93
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $202.02 / $360.46 / $3,949.61	Facility		$202.02	$360.46	$3,949.61
Kaiser Permanente Facility/Professional Facility Modifier 50 Low / Median / High Price $3,949.61 / $4,358.93 / $9,502.73	Facility	50	$3,949.61	$4,358.93	$9,502.73
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $209.41 / $335.00 / $1,049.08	Professional		$209.41	$335.00	$1,049.08
Molina Facility/Professional Professional Modifier Low / Median / High Price $38.92 / $247.58 / $420.95	Professional		$38.92	$247.58	$420.95
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $227.13 / $303.27 / $324.27	Facility		$227.13	$303.27	$324.27
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $213.82 / $221.19 / $541.04	Facility		$213.82	$221.19	$541.04
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $231.79 / $365.23 / $453.65	Professional		$231.79	$365.23	$453.65
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $3,153.55 / $4,319.34 / $8,267.12	Facility		$3,153.55	$4,319.34	$8,267.12
Regence BlueShield Facility/Professional Facility Modifier 50 Low / Median / High Price $4,730.33 / $6,479.01 / $12,400.70	Facility	50	$4,730.33	$6,479.01	$12,400.70
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $218.06 / $317.81 / $428.58	Professional		$218.06	$317.81	$428.58
United Facility/Professional Facility Modifier Low / Median / High Price $879.00 / $1,689.00 / $7,385.00	Facility		$879.00	$1,689.00	$7,385.00
United Facility/Professional Professional Modifier Low / Median / High Price $198.56 / $334.96 / $463.44	Professional		$198.56	$334.96	$463.44