Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $459.02 / $2,886.00 / $8,323.86	Facility		$459.02	$2,886.00	$8,323.86
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $172.03 / $369.76 / $605.66	Facility	52	$172.03	$369.76	$605.66
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $68.81 / $147.91 / $242.26	Facility	53	$68.81	$147.91	$242.26
Aetna Facility/Professional Professional Modifier Low / Median / High Price $265.87 / $484.56 / $1,211.32	Professional		$265.87	$484.56	$1,211.32
Aetna Facility/Professional Professional Modifier 53 Low / Median / High Price $52.63 / $93.24 / $200.54	Professional	53	$52.63	$93.24	$200.54
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $243.47 / $395.27 / $495.47	Professional		$243.47	$395.27	$495.47
Ambetter Facility/Professional Professional Modifier 53 Low / Median / High Price $364.50 / $364.50 / $364.50	Professional	53	$364.50	$364.50	$364.50
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 $513.22 / $909.50 / $909.50	Facility	52	$513.22	$909.50	$909.50
Asuris Northwest Health Facility/Professional Facility Modifier 53 Low / Median / High Price $128.30 / $227.37 / $227.37	Facility	53	$128.30	$227.37	$227.37
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $423.61 / $894.06 / $3,439.23	Professional		$423.61	$894.06	$3,439.23
Asuris Northwest Health Facility/Professional Professional Modifier 53 Low / Median / High Price $86.05 / $86.05 / $135.12	Professional	53	$86.05	$86.05	$135.12
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 $331.75 / $648.61 / $1,274.56	Professional		$331.75	$648.61	$1,274.56
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $376.65 / $710.47 / $1,327.09	Facility		$376.65	$710.47	$1,327.09
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $357.60 / $662.17 / $1,222.66	Professional		$357.60	$662.17	$1,222.66
Molina Facility/Professional Professional Modifier Low / Median / High Price $124.40 / $745.47 / $1,267.98	Professional		$124.40	$745.47	$1,267.98
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $519.04 / $848.89 / $963.30	Facility		$519.04	$848.89	$963.30
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $552.13 / $626.50 / $874.44	Facility		$552.13	$626.50	$874.44
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $412.51 / $678.47 / $1,183.33	Professional		$412.51	$678.47	$1,183.33
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 $430.71 / $702.91 / $1,052.64	Professional		$430.71	$702.91	$1,052.64
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 $494.13 / $748.54 / $1,314.03	Professional		$494.13	$748.54	$1,314.03
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $263.55 / $371.58 / $498.36	Professional		$263.55	$371.58	$498.36