Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $151.87 / $1,710.00 / $13,750.00	Facility		$151.87	$1,710.00	$13,750.00
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $52.97 / $153.75 / $308.92	Facility	52	$52.97	$153.75	$308.92
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $21.19 / $61.50 / $123.57	Facility	53	$21.19	$61.50	$123.57
Aetna Facility/Professional Professional Modifier Low / Median / High Price $105.49 / $209.25 / $466.42	Professional		$105.49	$209.25	$466.42
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $158.41 / $158.41 / $158.41	Professional		$158.41	$158.41	$158.41
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $485.15 / $9,032.98 / $17,279.07	Facility		$485.15	$9,032.98	$17,279.07
Asuris Northwest Health Facility/Professional Facility Modifier 52 Low / Median / High Price $169.34 / $301.54 / $301.54	Facility	52	$169.34	$301.54	$301.54
Asuris Northwest Health Facility/Professional Facility Modifier 53 Low / Median / High Price $42.33 / $75.39 / $75.39	Facility	53	$42.33	$75.39	$75.39
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $150.97 / $366.68 / $1,989.58	Professional		$150.97	$366.68	$1,989.58
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 $133.21 / $260.00 / $643.14	Professional		$133.21	$260.00	$643.14
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $161.24 / $322.94 / $2,601.75	Facility		$161.24	$322.94	$2,601.75
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $153.13 / $305.01 / $682.88	Professional		$153.13	$305.01	$682.88
Molina Facility/Professional Professional Modifier Low / Median / High Price $52.08 / $325.08 / $523.41	Professional		$52.08	$325.08	$523.41
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $233.16 / $407.49 / $446.08	Facility		$233.16	$407.49	$446.08
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $290.20 / $290.20 / $294.45	Facility		$290.20	$290.20	$294.45
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $148.63 / $276.86 / $531.94	Professional		$148.63	$276.86	$531.94
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $5,650.51 / $8,832.54 / $17,279.07	Facility		$5,650.51	$8,832.54	$17,279.07
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $141.07 / $255.60 / $491.49	Professional		$141.07	$255.60	$491.49
United Facility/Professional Facility Modifier Low / Median / High Price $648.00 / $1,875.00 / $4,911.00	Facility		$648.00	$1,875.00	$4,911.00
United Facility/Professional Professional Modifier Low / Median / High Price $267.51 / $384.55 / $610.72	Professional		$267.51	$384.55	$610.72