Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $222.07 / $2,399.00 / $6,259.93	Facility		$222.07	$2,399.00	$6,259.93
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $83.48 / $223.05 / $366.40	Facility	52	$83.48	$223.05	$366.40
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $33.39 / $71.44 / $138.69	Facility	53	$33.39	$71.44	$138.69
Aetna Facility/Professional Professional Modifier Low / Median / High Price $125.76 / $272.35 / $645.71	Professional		$125.76	$272.35	$645.71
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $107.23 / $219.21 / $317.94	Professional		$107.23	$219.21	$317.94
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $638.08 / $2,511.87 / $12,000.00	Facility		$638.08	$2,511.87	$12,000.00
Asuris Northwest Health Facility/Professional Facility Modifier 52 Low / Median / High Price $249.13 / $442.02 / $442.02	Facility	52	$249.13	$442.02	$442.02
Asuris Northwest Health Facility/Professional Facility Modifier 53 Low / Median / High Price $62.28 / $110.50 / $110.50	Facility	53	$62.28	$110.50	$110.50
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $201.69 / $528.07 / $2,132.08	Professional		$201.69	$528.07	$2,132.08
Cigna Facility/Professional Facility Modifier Low / Median / High Price $466.83 / $568.48 / $1,192.33	Facility		$466.83	$568.48	$1,192.33
Cigna Facility/Professional Professional Modifier Low / Median / High Price $164.86 / $350.58 / $807.61	Professional		$164.86	$350.58	$807.61
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $186.72 / $389.38 / $906.41	Facility		$186.72	$389.38	$906.41
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $177.12 / $352.32 / $776.69	Professional		$177.12	$352.32	$776.69
Molina Facility/Professional Professional Modifier Low / Median / High Price $72.32 / $436.72 / $742.68	Professional		$72.32	$436.72	$742.68
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $305.76 / $534.05 / $598.30	Facility		$305.76	$534.05	$598.30
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $394.39 / $416.80 / $666.60	Facility		$394.39	$416.80	$666.60
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $199.33 / $394.39 / $750.90	Professional		$199.33	$394.39	$750.90
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $1,814.55 / $2,568.87 / $4,913.96	Facility		$1,814.55	$2,568.87	$4,913.96
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $204.13 / $413.37 / $667.96	Professional		$204.13	$413.37	$667.96
United Facility/Professional Facility Modifier Low / Median / High Price $650.00 / $1,120.00 / $6,857.00	Facility		$650.00	$1,120.00	$6,857.00
United Facility/Professional Professional Modifier Low / Median / High Price $311.22 / $478.81 / $836.11	Professional		$311.22	$478.81	$836.11
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $128.87 / $235.76 / $321.83	Professional		$128.87	$235.76	$321.83