Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $147.56 / $2,518.30 / $17,100.00	Facility		$147.56	$2,518.30	$17,100.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $111.92 / $1,338.22 / $2,504.61	Professional		$111.92	$1,338.22	$2,504.61
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $2,685.28 / $2,685.28 / $2,685.28	Professional	50	$2,685.28	$2,685.28	$2,685.28
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $1,424.28 / $1,424.28 / $1,424.28	Professional		$1,424.28	$1,424.28	$1,424.28
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $290.26 / $4,857.60 / $9,885.68	Facility		$290.26	$4,857.60	$9,885.68
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $188.54 / $2,338.67 / $9,379.36	Professional		$188.54	$2,338.67	$9,379.36
Asuris Northwest Health Facility/Professional Professional Modifier 50 Low / Median / High Price $282.81 / $484.50 / $4,411.50	Professional	50	$282.81	$484.50	$4,411.50
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,323.83 / $2,323.83 / $2,323.83	Facility		$2,323.83	$2,323.83	$2,323.83
Cigna Facility/Professional Professional Modifier Low / Median / High Price $184.42 / $1,894.80 / $3,933.27	Professional		$184.42	$1,894.80	$3,933.27
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $196.65 / $1,749.26 / $4,415.62	Facility		$196.65	$1,749.26	$4,415.62
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $186.39 / $1,565.69 / $4,044.01	Professional		$186.39	$1,565.69	$4,044.01
Molina Facility/Professional Professional Modifier Low / Median / High Price $314.73 / $1,917.88 / $3,189.88	Professional		$314.73	$1,917.88	$3,189.88
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $224.80 / $2,407.48 / $2,877.65	Facility		$224.80	$2,407.48	$2,877.65
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,746.65 / $1,746.65 / $1,843.71	Facility		$1,746.65	$1,746.65	$1,843.71
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $200.57 / $388.05 / $3,201.69	Professional		$200.57	$388.05	$3,201.69
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $3,770.96 / $5,167.93 / $9,885.68	Facility		$3,770.96	$5,167.93	$9,885.68
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $173.63 / $358.25 / $2,958.23	Professional		$173.63	$358.25	$2,958.23
United Facility/Professional Facility Modifier Low / Median / High Price $1,120.00 / $3,323.00 / $7,385.00	Facility		$1,120.00	$3,323.00	$7,385.00
United Facility/Professional Professional Modifier Low / Median / High Price $1,889.81 / $2,662.91 / $3,818.25	Professional		$1,889.81	$2,662.91	$3,818.25