Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $467.79 / $1,856.48 / $13,809.00	Facility		$467.79	$1,856.48	$13,809.00
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $175.37 / $377.04 / $973.22	Facility	52	$175.37	$377.04	$973.22
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $70.15 / $150.82 / $389.29	Facility	53	$70.15	$150.82	$389.29
Aetna Facility/Professional Professional Modifier Low / Median / High Price $286.37 / $606.20 / $1,365.86	Professional		$286.37	$606.20	$1,365.86
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $223.91 / $223.91 / $241.93	Professional		$223.91	$223.91	$241.93
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $907.60 / $3,269.98 / $16,394.00	Facility		$907.60	$3,269.98	$16,394.00
Asuris Northwest Health Facility/Professional Facility Modifier 52 Low / Median / High Price $523.28 / $926.46 / $926.46	Facility	52	$523.28	$926.46	$926.46
Asuris Northwest Health Facility/Professional Facility Modifier 53 Low / Median / High Price $130.82 / $231.61 / $231.61	Facility	53	$130.82	$231.61	$231.61
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $435.20 / $1,223.58 / $4,908.96	Professional		$435.20	$1,223.58	$4,908.96
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 $340.00 / $756.96 / $1,887.59	Professional		$340.00	$756.96	$1,887.59
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $402.64 / $854.51 / $1,711.27	Facility		$402.64	$854.51	$1,711.27
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $377.14 / $769.16 / $1,629.09	Professional		$377.14	$769.16	$1,629.09
Molina Facility/Professional Professional Modifier Low / Median / High Price $176.17 / $1,074.02 / $1,828.16	Professional		$176.17	$1,074.02	$1,828.16
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $782.65 / $1,253.92 / $1,370.15	Facility		$782.65	$1,253.92	$1,370.15
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $552.13 / $907.60 / $932.73	Facility		$552.13	$907.60	$932.73
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $420.26 / $847.27 / $1,733.86	Professional		$420.26	$847.27	$1,733.86
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 $438.33 / $901.32 / $1,542.13	Professional		$438.33	$901.32	$1,542.13
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 $747.03 / $1,181.17 / $1,951.94	Professional		$747.03	$1,181.17	$1,951.94
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $268.56 / $535.02 / $731.46	Professional		$268.56	$535.02	$731.46