Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $275.19 / $840.18 / $9,574.57	Facility		$275.19	$840.18	$9,574.57
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $136.24 / $331.27 / $552.33	Facility	52	$136.24	$331.27	$552.33
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $54.49 / $116.75 / $212.18	Facility	53	$54.49	$116.75	$212.18
Aetna Facility/Professional Professional Modifier Low / Median / High Price $209.61 / $422.73 / $947.41	Professional		$209.61	$422.73	$947.41
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $144.82 / $167.39 / $178.61	Professional		$144.82	$167.39	$178.61
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $749.59 / $3,269.98 / $16,394.00	Facility		$749.59	$3,269.98	$16,394.00
Asuris Northwest Health Facility/Professional Facility Modifier 52 Low / Median / High Price $405.92 / $721.81 / $721.81	Facility	52	$405.92	$721.81	$721.81
Asuris Northwest Health Facility/Professional Facility Modifier 53 Low / Median / High Price $101.48 / $180.45 / $180.45	Facility	53	$101.48	$180.45	$180.45
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $331.09 / $814.83 / $3,278.48	Professional		$331.09	$814.83	$3,278.48
Cigna Facility/Professional Facility Modifier Low / Median / High Price $625.25 / $761.81 / $1,499.24	Facility		$625.25	$761.81	$1,499.24
Cigna Facility/Professional Professional Modifier Low / Median / High Price $269.77 / $533.47 / $1,238.97	Professional		$269.77	$533.47	$1,238.97
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $308.70 / $595.58 / $1,252.51	Facility		$308.70	$595.58	$1,252.51
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $291.50 / $566.16 / $1,147.08	Professional		$291.50	$566.16	$1,147.08
Molina Facility/Professional Professional Modifier Low / Median / High Price $116.80 / $707.92 / $1,200.51	Professional		$116.80	$707.92	$1,200.51
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $484.01 / $804.40 / $893.78	Facility		$484.01	$804.40	$893.78
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $552.13 / $614.72 / $874.44	Facility		$552.13	$614.72	$874.44
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $325.58 / $605.98 / $1,151.58	Professional		$325.58	$605.98	$1,151.58
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $2,168.55 / $3,344.18 / $6,397.05	Facility		$2,168.55	$3,344.18	$6,397.05
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $339.29 / $617.10 / $1,007.10	Professional		$339.29	$617.10	$1,007.10
United Facility/Professional Facility Modifier Low / Median / High Price $650.00 / $1,355.00 / $4,271.00	Facility		$650.00	$1,355.00	$4,271.00
United Facility/Professional Professional Modifier Low / Median / High Price $457.52 / $722.40 / $1,264.45	Professional		$457.52	$722.40	$1,264.45
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $209.24 / $360.82 / $489.82	Professional		$209.24	$360.82	$489.82