Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,008.15 / $10,778.04 / $20,898.68	Facility		$1,008.15	$10,778.04	$20,898.68
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $15,137.08 / $15,137.08 / $25,627.15	Facility	50	$15,137.08	$15,137.08	$25,627.15
Aetna Facility/Professional Professional Modifier Low / Median / High Price $543.25 / $801.42 / $3,287.20	Professional		$543.25	$801.42	$3,287.20
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $509.12 / $1,002.00 / $1,199.82	Professional		$509.12	$1,002.00	$1,199.82
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $5,490.98 / $9,167.59 / $17,907.41	Facility		$5,490.98	$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 Facility Modifier AS Low / Median / High Price $510.42 / $849.00 / $849.00	Facility	AS	$510.42	$849.00	$849.00
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $775.85 / $1,185.22 / $5,283.53	Professional		$775.85	$1,185.22	$5,283.53
Cigna Facility/Professional Facility Modifier Low / Median / High Price $883.20 / $1,664.69 / $3,740.43	Facility		$883.20	$1,664.69	$3,740.43
Cigna Facility/Professional Professional Modifier Low / Median / High Price $578.17 / $1,015.20 / $1,670.05	Professional		$578.17	$1,015.20	$1,670.05
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $612.17 / $1,238.84 / $3,280.24	Facility		$612.17	$1,238.84	$3,280.24
Kaiser Permanente Facility/Professional Facility Modifier 50 Low / Median / High Price $7,533.67 / $9,273.01 / $22,310.81	Facility	50	$7,533.67	$9,273.01	$22,310.81
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $592.80 / $1,164.86 / $2,824.57	Professional		$592.80	$1,164.86	$2,824.57
Molina Facility/Professional Professional Modifier Low / Median / High Price $77.42 / $317.80 / $1,079.46	Professional		$77.42	$317.80	$1,079.46
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $810.03 / $1,045.20 / $1,105.50	Facility		$810.03	$1,045.20	$1,105.50
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $730.24 / $754.05 / $2,961.46	Facility		$730.24	$754.05	$2,961.46
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $839.04 / $1,199.55 / $1,496.72	Professional		$839.04	$1,199.55	$1,496.72
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $6,145.87 / $9,167.59 / $17,546.59	Facility		$6,145.87	$9,167.59	$17,546.59
Regence BlueShield Facility/Professional Facility Modifier 50 Low / Median / High Price $9,218.81 / $13,751.39 / $26,319.89	Facility	50	$9,218.81	$13,751.39	$26,319.89
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $744.74 / $1,073.29 / $1,437.04	Professional		$744.74	$1,073.29	$1,437.04
United Facility/Professional Facility Modifier Low / Median / High Price $2,155.00 / $3,297.00 / $11,941.00	Facility		$2,155.00	$3,297.00	$11,941.00
United Facility/Professional Professional Modifier Low / Median / High Price $670.80 / $920.40 / $1,551.36	Professional		$670.80	$920.40	$1,551.36
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $459.38 / $459.38 / $599.91	Professional		$459.38	$459.38	$599.91