Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $420.41 / $5,116.62 / $25,674.15	Facility		$420.41	$5,116.62	$25,674.15
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $149.69 / $306.60 / $1,662.70	Facility	52	$149.69	$306.60	$1,662.70
Aetna Facility/Professional Professional Modifier Low / Median / High Price $207.01 / $1,017.33 / $2,068.05	Professional		$207.01	$1,017.33	$2,068.05
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $103.51 / $508.67 / $1,197.44	Professional	52	$103.51	$508.67	$1,197.44
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $240.55 / $240.55 / $614.67	Professional		$240.55	$240.55	$614.67
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $1,623.72 / $15,224.93 / $30,984.11	Facility		$1,623.72	$15,224.93	$30,984.11
Asuris Northwest Health Facility/Professional Facility Modifier 52 Low / Median / High Price $472.27 / $848.95 / $848.95	Facility	52	$472.27	$848.95	$848.95
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $376.25 / $2,174.08 / $8,740.16	Professional		$376.25	$2,174.08	$8,740.16
Cigna Facility/Professional Facility Modifier Low / Median / High Price $6,228.57 / $6,228.57 / $6,228.57	Facility		$6,228.57	$6,228.57	$6,228.57
Cigna Facility/Professional Professional Modifier Low / Median / High Price $370.52 / $757.12 / $3,628.07	Professional		$370.52	$757.12	$3,628.07
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $367.63 / $1,888.58 / $5,061.89	Facility		$367.63	$1,888.58	$5,061.89
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $367.63 / $1,510.86 / $3,567.07	Professional		$367.63	$1,510.86	$3,567.07
Molina Facility/Professional Professional Modifier Low / Median / High Price $303.21 / $1,854.61 / $3,074.01	Professional		$303.21	$1,854.61	$3,074.01
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $451.31 / $2,261.41 / $2,578.71	Facility		$451.31	$2,261.41	$2,578.71
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,623.72 / $1,623.72 / $1,694.67	Facility		$1,623.72	$1,623.72	$1,694.67
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $401.72 / $777.22 / $2,976.35	Professional		$401.72	$777.22	$2,976.35
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $11,819.11 / $16,197.56 / $30,984.11	Facility		$11,819.11	$16,197.56	$30,984.11
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $375.87 / $717.52 / $2,750.02	Professional		$375.87	$717.52	$2,750.02
United Facility/Professional Facility Modifier Low / Median / High Price $3,028.00 / $11,540.00 / $20,708.00	Facility		$3,028.00	$11,540.00	$20,708.00
United Facility/Professional Professional Modifier Low / Median / High Price $1,553.16 / $2,236.65 / $3,550.08	Professional		$1,553.16	$2,236.65	$3,550.08