Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $717.25 / $7,132.60 / $15,904.80	Facility		$717.25	$7,132.60	$15,904.80
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $18,889.96 / $18,889.96 / $18,889.96	Facility	50	$18,889.96	$18,889.96	$18,889.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $300.18 / $598.12 / $2,023.97	Professional		$300.18	$598.12	$2,023.97
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $369.60 / $369.60 / $369.60	Professional		$369.60	$369.60	$369.60
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $1,838.80 / $9,167.59 / $17,907.41	Facility		$1,838.80	$9,167.59	$17,907.41
Asuris Northwest Health Facility/Professional Facility Modifier 50 Low / Median / High Price $9,601.43 / $13,759.25 / $26,618.73	Facility	50	$9,601.43	$13,759.25	$26,618.73
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $640.25 / $1,064.03 / $4,033.04	Professional		$640.25	$1,064.03	$4,033.04
Cigna Facility/Professional Facility Modifier Low / Median / High Price $714.97 / $870.49 / $3,740.43	Facility		$714.97	$870.49	$3,740.43
Cigna Facility/Professional Professional Modifier Low / Median / High Price $452.12 / $832.80 / $1,546.49	Professional		$452.12	$832.80	$1,546.49
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $452.89 / $861.28 / $2,806.97	Facility		$452.89	$861.28	$2,806.97
Kaiser Permanente Facility/Professional Facility Modifier 50 Low / Median / High Price $5,680.35 / $9,273.01 / $22,310.81	Facility	50	$5,680.35	$9,273.01	$22,310.81
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $452.89 / $832.64 / $1,820.53	Professional		$452.89	$832.64	$1,820.53
Molina Facility/Professional Professional Modifier Low / Median / High Price $76.84 / $309.69 / $1,050.18	Professional		$76.84	$309.69	$1,050.18
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $614.26 / $1,011.97 / $1,087.41	Facility		$614.26	$1,011.97	$1,087.41
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $718.46 / $741.71 / $2,961.46	Facility		$718.46	$741.71	$2,961.46
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $637.60 / $949.63 / $1,333.60	Professional		$637.60	$949.63	$1,333.60
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $5,948.17 / $9,167.59 / $17,546.59	Facility		$5,948.17	$9,167.59	$17,546.59
Regence BlueShield Facility/Professional Facility Modifier 50 Low / Median / High Price $8,922.26 / $13,751.39 / $26,319.89	Facility	50	$8,922.26	$13,751.39	$26,319.89
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $614.49 / $890.62 / $1,315.44	Professional		$614.49	$890.62	$1,315.44
United Facility/Professional Facility Modifier Low / Median / High Price $1,547.00 / $2,408.00 / $10,522.00	Facility		$1,547.00	$2,408.00	$10,522.00
United Facility/Professional Professional Modifier Low / Median / High Price $579.78 / $880.01 / $1,544.81	Professional		$579.78	$880.01	$1,544.81
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $429.52 / $448.34 / $601.58	Professional		$429.52	$448.34	$601.58