Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $405.12 / $2,837.65 / $13,809.00	Facility		$405.12	$2,837.65	$13,809.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $2,614.50 / $5,033.43 / $11,904.30	Facility	50	$2,614.50	$5,033.43	$11,904.30
Aetna Facility/Professional Professional Modifier Low / Median / High Price $313.47 / $906.69 / $3,096.71	Professional		$313.47	$906.69	$3,096.71
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $2,332.66 / $3,142.28 / $6,100.39	Professional	50	$2,332.66	$3,142.28	$6,100.39
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $199.39 / $460.30 / $550.16	Professional		$199.39	$460.30	$550.16
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $736.04 / $736.04 / $782.51	Professional	50	$736.04	$736.04	$782.51
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $2,500.38 / $2,500.38 / $8,980.00	Facility		$2,500.38	$2,500.38	$8,980.00
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $526.61 / $2,649.68 / $11,617.10	Professional		$526.61	$2,649.68	$11,617.10
Asuris Northwest Health Facility/Professional Professional Modifier 50 Low / Median / High Price $695.84 / $2,495.77 / $3,851.18	Professional	50	$695.84	$2,495.77	$3,851.18
Cigna Facility/Professional Professional Modifier Low / Median / High Price $373.57 / $964.83 / $4,164.60	Professional		$373.57	$964.83	$4,164.60
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $412.32 / $1,326.80 / $4,196.16	Facility		$412.32	$1,326.80	$4,196.16
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $425.20 / $1,326.80 / $4,075.85	Professional		$425.20	$1,326.80	$4,075.85
Molina Facility/Professional Professional Modifier Low / Median / High Price $361.00 / $2,149.03 / $3,614.35	Professional		$361.00	$2,149.03	$3,614.35
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $594.29 / $2,657.76 / $3,006.29	Facility		$594.29	$2,657.76	$3,006.29
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,908.43 / $1,908.43 / $1,997.28	Facility		$1,908.43	$1,908.43	$1,997.28
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $518.71 / $1,301.33 / $3,788.05	Professional		$518.71	$1,301.33	$3,788.05
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $526.61 / $1,083.03 / $3,549.91	Professional		$526.61	$1,083.03	$3,549.91
United Facility/Professional Facility Modifier Low / Median / High Price $414.00 / $666.00 / $6,216.00	Facility		$414.00	$666.00	$6,216.00
United Facility/Professional Professional Modifier Low / Median / High Price $1,688.80 / $2,945.18 / $4,339.04	Professional		$1,688.80	$2,945.18	$4,339.04
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $297.39 / $297.39 / $1,551.51	Professional		$297.39	$297.39	$1,551.51