Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $783.69 / $1,262.05 / $10,227.50	Facility		$783.69	$1,262.05	$10,227.50
Aetna Facility/Professional Professional Modifier Low / Median / High Price $865.28 / $2,422.37 / $10,698.80	Professional		$865.28	$2,422.37	$10,698.80
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $773.54 / $773.54 / $773.54	Professional		$773.54	$773.54	$773.54
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $3,912.83 / $15,224.93 / $30,984.11	Facility		$3,912.83	$15,224.93	$30,984.11
Asuris Northwest Health Facility/Professional Facility Modifier 50 Low / Median / High Price $17,563.64 / $24,296.34 / $47,003.87	Facility	50	$17,563.64	$24,296.34	$47,003.87
Asuris Northwest Health Facility/Professional Facility Modifier 53 Low / Median / High Price $210.52 / $392.38 / $392.38	Facility	53	$210.52	$392.38	$392.38
Asuris Northwest Health Facility/Professional Facility Modifier AS Low / Median / High Price $105.26 / $196.19 / $196.19	Facility	AS	$105.26	$196.19	$196.19
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $784.55 / $5,462.56 / $20,972.32	Professional		$784.55	$5,462.56	$20,972.32
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $698.69 / $5,061.89 / $10,283.39	Facility		$698.69	$5,061.89	$10,283.39
Kaiser Permanente Facility/Professional Facility Modifier 50 Low / Median / High Price $13,797.66 / $24,314.18 / $44,150.58	Facility	50	$13,797.66	$24,314.18	$44,150.58
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $683.85 / $4,224.49 / $9,765.00	Professional		$683.85	$4,224.49	$9,765.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $707.27 / $4,323.60 / $7,211.06	Professional		$707.27	$4,323.60	$7,211.06
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $872.34 / $5,495.35 / $7,146.05	Facility		$872.34	$5,495.35	$7,146.05
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $3,912.83 / $3,912.83 / $4,148.12	Facility		$3,912.83	$3,912.83	$4,148.12
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $743.66 / $1,438.80 / $7,172.39	Professional		$743.66	$1,438.80	$7,172.39
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $11,709.09 / $16,197.56 / $30,984.11	Facility		$11,709.09	$16,197.56	$30,984.11
Regence BlueShield Facility/Professional Facility Modifier 50 Low / Median / High Price $17,563.64 / $24,296.34 / $46,476.17	Facility	50	$17,563.64	$24,296.34	$46,476.17
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $714.44 / $1,328.29 / $6,626.99	Professional		$714.44	$1,328.29	$6,626.99
United Facility/Professional Professional Modifier Low / Median / High Price $4,296.60 / $6,214.77 / $9,131.31	Professional		$4,296.60	$6,214.77	$9,131.31