Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $495.11 / $7,394.00 / $18,800.00	Facility		$495.11	$7,394.00	$18,800.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $7,071.30 / $14,788.00 / $27,132.20	Facility	50	$7,071.30	$14,788.00	$27,132.20
Aetna Facility/Professional Professional Modifier Low / Median / High Price $339.00 / $1,250.00 / $2,413.16	Professional		$339.00	$1,250.00	$2,413.16
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $742.66 / $1,208.25 / $1,208.25	Professional	50	$742.66	$1,208.25	$1,208.25
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $229.37 / $416.05 / $1,163.56	Professional		$229.37	$416.05	$1,163.56
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $1,881.78 / $9,032.98 / $23,371.01	Facility		$1,881.78	$9,032.98	$23,371.01
Asuris Northwest Health Facility/Professional Facility Modifier 50 Low / Median / High Price $10,349.67 / $13,549.47 / $26,212.89	Facility	50	$10,349.67	$13,549.47	$26,212.89
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $470.61 / $2,017.39 / $12,060.37	Professional		$470.61	$2,017.39	$12,060.37
Asuris Northwest Health Facility/Professional Professional Modifier 50 Low / Median / High Price $651.90 / $1,609.50 / $5,217.00	Professional	50	$651.90	$1,609.50	$5,217.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $3,763.00 / $3,763.00 / $3,763.00	Facility		$3,763.00	$3,763.00	$3,763.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $431.72 / $875.12 / $3,273.53	Professional		$431.72	$875.12	$3,273.53
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $462.87 / $2,299.17 / $4,260.34	Facility		$462.87	$2,299.17	$4,260.34
Kaiser Permanente Facility/Professional Facility Modifier 50 Low / Median / High Price $8,977.36 / $11,895.06 / $21,599.49	Facility	50	$8,977.36	$11,895.06	$21,599.49
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $438.72 / $1,839.34 / $4,010.06	Professional		$438.72	$1,839.34	$4,010.06
Molina Facility/Professional Professional Modifier Low / Median / High Price $257.85 / $1,573.45 / $2,628.09	Professional		$257.85	$1,573.45	$2,628.09
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $653.86 / $2,124.57 / $3,104.22	Facility		$653.86	$2,124.57	$3,104.22
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,449.15 / $1,449.15 / $1,512.11	Facility		$1,449.15	$1,449.15	$1,512.11
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $486.47 / $906.20 / $2,656.35	Professional		$486.47	$906.20	$2,656.35
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $6,899.78 / $9,027.82 / $17,279.07	Facility		$6,899.78	$9,027.82	$17,279.07
Regence BlueShield Facility/Professional Facility Modifier 50 Low / Median / High Price $10,349.67 / $13,541.73 / $25,918.61	Facility	50	$10,349.67	$13,541.73	$25,918.61
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $416.87 / $836.60 / $2,454.35	Professional		$416.87	$836.60	$2,454.35
United Facility/Professional Facility Modifier Low / Median / High Price $2,155.00 / $6,295.00 / $11,941.00	Facility		$2,155.00	$6,295.00	$11,941.00
United Facility/Professional Professional Modifier Low / Median / High Price $1,712.93 / $2,413.67 / $3,393.92	Professional		$1,712.93	$2,413.67	$3,393.92