Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $277.89 / $3,438.72 / $9,667.73	Facility		$277.89	$3,438.72	$9,667.73
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $104.37 / $223.64 / $1,401.57	Facility	52	$104.37	$223.64	$1,401.57
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $41.75 / $89.46 / $560.63	Facility	53	$41.75	$89.46	$560.63
Aetna Facility/Professional Professional Modifier Low / Median / High Price $148.69 / $300.31 / $2,170.80	Professional		$148.69	$300.31	$2,170.80
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $132.19 / $236.18 / $301.23	Professional		$132.19	$236.18	$301.23
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $1,063.56 / $5,068.58 / $16,394.00	Facility		$1,063.56	$5,068.58	$16,394.00
Asuris Northwest Health Facility/Professional Facility Modifier 52 Low / Median / High Price $310.61 / $551.04 / $551.04	Facility	52	$310.61	$551.04	$551.04
Asuris Northwest Health Facility/Professional Facility Modifier 53 Low / Median / High Price $77.65 / $137.76 / $137.76	Facility	53	$77.65	$137.76	$137.76
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $244.71 / $1,960.53 / $7,882.64	Professional		$244.71	$1,960.53	$7,882.64
Cigna Facility/Professional Facility Modifier Low / Median / High Price $625.25 / $761.81 / $2,046.84	Facility		$625.25	$761.81	$2,046.84
Cigna Facility/Professional Professional Modifier Low / Median / High Price $203.35 / $480.02 / $3,041.28	Professional		$203.35	$480.02	$3,041.28
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $215.04 / $524.16 / $2,590.94	Facility		$215.04	$524.16	$2,590.94
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $197.75 / $420.64 / $2,462.58	Professional		$197.75	$420.64	$2,462.58
Molina Facility/Professional Professional Modifier Low / Median / High Price $274.76 / $1,697.57 / $2,885.02	Professional		$274.76	$1,697.57	$2,885.02
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $305.89 / $1,930.94 / $2,146.67	Facility		$305.89	$1,930.94	$2,146.67
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $726.69 / $1,464.23 / $1,545.18	Facility		$726.69	$1,464.23	$1,545.18
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $247.60 / $504.80 / $2,898.62	Professional		$247.60	$504.80	$2,898.62
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $3,496.71 / $5,392.38 / $10,315.01	Facility		$3,496.71	$5,392.38	$10,315.01
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $252.38 / $493.36 / $2,479.90	Professional		$252.38	$493.36	$2,479.90
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 $272.45 / $1,798.50 / $3,157.18	Professional		$272.45	$1,798.50	$3,157.18
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $160.22 / $845.87 / $1,189.82	Professional		$160.22	$845.87	$1,189.82