Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $746.07 / $8,746.00 / $17,541.37	Facility		$746.07	$8,746.00	$17,541.37
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $9,182.45 / $10,016.49 / $15,970.00	Facility	50	$9,182.45	$10,016.49	$15,970.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $393.86 / $588.04 / $1,300.47	Professional		$393.86	$588.04	$1,300.47
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $573.22 / $822.44 / $996.90	Professional		$573.22	$822.44	$996.90
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $2,158.52 / $10,802.03 / $26,542.00	Facility		$2,158.52	$10,802.03	$26,542.00
Asuris Northwest Health Facility/Professional Facility Modifier 50 Low / Median / High Price $10,306.59 / $16,203.05 / $31,346.52	Facility	50	$10,306.59	$16,203.05	$31,346.52
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $775.55 / $1,268.35 / $4,197.28	Professional		$775.55	$1,268.35	$4,197.28
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,186.71 / $2,186.71 / $3,643.05	Facility		$2,186.71	$2,186.71	$3,643.05
Cigna Facility/Professional Professional Modifier Low / Median / High Price $648.60 / $1,086.24 / $1,724.01	Professional		$648.60	$1,086.24	$1,724.01
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $573.72 / $1,002.54 / $3,225.00	Facility		$573.72	$1,002.54	$3,225.00
Kaiser Permanente Facility/Professional Facility Modifier 50 Low / Median / High Price $6,433.53 / $9,505.52 / $22,870.24	Facility	50	$6,433.53	$9,505.52	$22,870.24
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $613.54 / $1,002.54 / $1,780.31	Professional		$613.54	$1,002.54	$1,780.31
Molina Facility/Professional Professional Modifier Low / Median / High Price $73.20 / $262.55 / $1,164.92	Professional		$73.20	$262.55	$1,164.92
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $688.95 / $1,030.46 / $1,161.10	Facility		$688.95	$1,030.46	$1,161.10
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $776.44 / $791.98 / $1,239.50	Facility		$776.44	$791.98	$1,239.50
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $768.92 / $1,097.95 / $1,495.78	Professional		$768.92	$1,097.95	$1,495.78
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $7,004.63 / $10,795.86 / $20,663.07	Facility		$7,004.63	$10,795.86	$20,663.07
Regence BlueShield Facility/Professional Facility Modifier 50 Low / Median / High Price $10,506.95 / $16,193.79 / $30,994.61	Facility	50	$10,506.95	$16,193.79	$30,994.61
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $746.90 / $1,013.91 / $1,396.47	Professional		$746.90	$1,013.91	$1,396.47
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 $676.81 / $1,212.77 / $1,660.66	Professional		$676.81	$1,212.77	$1,660.66