Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $988.00 / $1,937.10 / $17,967.00	Facility		$988.00	$1,937.10	$17,967.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $3,022.50 / $9,023.25 / $11,036.63	Facility	50	$3,022.50	$9,023.25	$11,036.63
Aetna Facility/Professional Professional Modifier Low / Median / High Price $588.99 / $867.85 / $1,856.21	Professional		$588.99	$867.85	$1,856.21
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $1,432.62 / $2,037.06 / $5,685.00	Professional	50	$1,432.62	$2,037.06	$5,685.00
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $455.14 / $455.14 / $455.14	Professional	50	$455.14	$455.14	$455.14
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $4,731.12 / $10,802.03 / $26,542.00	Facility		$4,731.12	$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 $1,138.59 / $1,834.91 / $6,141.92	Professional		$1,138.59	$1,834.91	$6,141.92
Asuris Northwest Health Facility/Professional Professional Modifier 50 Low / Median / High Price $915.13 / $2,038.63 / $2,809.50	Professional	50	$915.13	$2,038.63	$2,809.50
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 $979.33 / $1,582.27 / $2,511.28	Professional		$979.33	$1,582.27	$2,511.28
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $843.36 / $1,549.77 / $3,225.00	Facility		$843.36	$1,549.77	$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 $916.46 / $1,522.06 / $2,303.08	Professional		$916.46	$1,522.06	$2,303.08
Molina Facility/Professional Professional Modifier Low / Median / High Price $78.68 / $429.15 / $1,713.51	Professional		$78.68	$429.15	$1,713.51
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,011.64 / $1,537.09 / $1,678.35	Facility		$1,011.64	$1,537.09	$1,678.35
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,116.65 / $1,144.79 / $1,239.50	Facility		$1,116.65	$1,144.79	$1,239.50
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,125.00 / $1,597.45 / $2,170.61	Professional		$1,125.00	$1,597.45	$2,170.61
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 $1,086.69 / $1,462.35 / $2,026.49	Professional		$1,086.69	$1,462.35	$2,026.49
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 $1,048.08 / $1,667.39 / $2,408.94	Professional		$1,048.08	$1,667.39	$2,408.94