Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $511.18 / $1,091.43 / $16,398.00	Facility		$511.18	$1,091.43	$16,398.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $1,423.46 / $2,619.46 / $5,557.44	Facility	50	$1,423.46	$2,619.46	$5,557.44
Aetna Facility/Professional Professional Modifier Low / Median / High Price $273.88 / $412.86 / $969.42	Professional		$273.88	$412.86	$969.42
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $210.61 / $1,127.68 / $7,597.80	Professional	50	$210.61	$1,127.68	$7,597.80
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $225.05 / $4,319.34 / $8,267.12	Facility		$225.05	$4,319.34	$8,267.12
Asuris Northwest Health Facility/Professional Facility Modifier 50 Low / Median / High Price $5,039.18 / $6,732.50 / $12,541.50	Facility	50	$5,039.18	$6,732.50	$12,541.50
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $486.81 / $815.41 / $2,859.28	Professional		$486.81	$815.41	$2,859.28
Asuris Northwest Health Facility/Professional Professional Modifier 50 Low / Median / High Price $410.80 / $741.63 / $1,102.58	Professional	50	$410.80	$741.63	$1,102.58
Cigna Facility/Professional Facility Modifier Low / Median / High Price $293.41 / $293.41 / $488.81	Facility		$293.41	$293.41	$488.81
Cigna Facility/Professional Professional Modifier Low / Median / High Price $450.15 / $715.10 / $1,163.01	Professional		$450.15	$715.10	$1,163.01
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $348.43 / $651.12 / $1,215.00	Facility		$348.43	$651.12	$1,215.00
Kaiser Permanente Facility/Professional Facility Modifier 50 Low / Median / High Price $6,447.65 / $8,266.54 / $19,889.25	Facility	50	$6,447.65	$8,266.54	$19,889.25
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $362.39 / $628.30 / $914.71	Professional		$362.39	$628.30	$914.71
Molina Facility/Professional Professional Modifier Low / Median / High Price $40.66 / $326.96 / $873.29	Professional		$40.66	$326.96	$873.29
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $469.09 / $720.25 / $775.86	Facility		$469.09	$720.25	$775.86
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $225.05 / $517.78 / $529.21	Facility		$225.05	$517.78	$529.21
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $498.26 / $696.07 / $970.06	Professional		$498.26	$696.07	$970.06
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $3,301.18 / $4,404.18 / $8,267.12	Facility		$3,301.18	$4,404.18	$8,267.12
Regence BlueShield Facility/Professional Facility Modifier 50 Low / Median / High Price $4,951.77 / $6,606.29 / $12,400.70	Facility	50	$4,951.77	$6,606.29	$12,400.70
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $464.73 / $644.66 / $896.29	Professional		$464.73	$644.66	$896.29
United Facility/Professional Facility Modifier Low / Median / High Price $1,550.00 / $2,431.00 / $11,261.00	Facility		$1,550.00	$2,431.00	$11,261.00
United Facility/Professional Professional Modifier Low / Median / High Price $473.00 / $757.02 / $1,117.07	Professional		$473.00	$757.02	$1,117.07