Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $591.07 / $3,354.00 / $14,960.00	Facility		$591.07	$3,354.00	$14,960.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $11,262.43 / $11,262.43 / $12,048.34	Facility	50	$11,262.43	$11,262.43	$12,048.34
Aetna Facility/Professional Professional Modifier Low / Median / High Price $414.85 / $685.24 / $1,417.06	Professional		$414.85	$685.24	$1,417.06
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $899.14 / $899.14 / $899.14	Professional	50	$899.14	$899.14	$899.14
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $438.05 / $555.90 / $579.86	Professional		$438.05	$555.90	$579.86
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $674.53 / $8,490.57 / $17,279.07	Facility		$674.53	$8,490.57	$17,279.07
Asuris Northwest Health Facility/Professional Facility Modifier 50 Low / Median / High Price $9,667.96 / $13,549.47 / $26,212.89	Facility	50	$9,667.96	$13,549.47	$26,212.89
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $592.96 / $931.06 / $4,387.22	Professional		$592.96	$931.06	$4,387.22
Asuris Northwest Health Facility/Professional Professional Modifier 50 Low / Median / High Price $924.84 / $1,129.50 / $1,704.00	Professional	50	$924.84	$1,129.50	$1,704.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $552.41 / $552.41 / $552.41	Facility		$552.41	$552.41	$552.41
Cigna Facility/Professional Professional Modifier Low / Median / High Price $646.94 / $956.35 / $1,474.64	Professional		$646.94	$956.35	$1,474.64
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $516.15 / $1,179.50 / $2,923.63	Facility		$516.15	$1,179.50	$2,923.63
Kaiser Permanente Facility/Professional Facility Modifier 50 Low / Median / High Price $6,901.60 / $11,895.06 / $21,599.49	Facility	50	$6,901.60	$11,895.06	$21,599.49
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $664.61 / $1,152.80 / $1,689.01	Professional		$664.61	$1,152.80	$1,689.01
Molina Facility/Professional Professional Modifier Low / Median / High Price $80.21 / $404.23 / $1,043.69	Professional		$80.21	$404.23	$1,043.69
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $800.24 / $988.92 / $1,486.06	Facility		$800.24	$988.92	$1,486.06
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $674.53 / $674.53 / $679.95	Facility		$674.53	$674.53	$679.95
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $583.77 / $842.70 / $1,234.04	Professional		$583.77	$842.70	$1,234.04
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $5,857.48 / $9,027.82 / $17,279.07	Facility		$5,857.48	$9,027.82	$17,279.07
Regence BlueShield Facility/Professional Facility Modifier 50 Low / Median / High Price $8,786.21 / $13,541.73 / $25,918.61	Facility	50	$8,786.21	$13,541.73	$25,918.61
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $554.05 / $799.67 / $1,146.10	Professional		$554.05	$799.67	$1,146.10
United Facility/Professional Facility Modifier Low / Median / High Price $2,155.00 / $6,594.00 / $12,835.00	Facility		$2,155.00	$6,594.00	$12,835.00
United Facility/Professional Professional Modifier Low / Median / High Price $652.08 / $1,047.06 / $1,488.67	Professional		$652.08	$1,047.06	$1,488.67