Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $449.78 / $5,128.00 / $11,522.02	Facility		$449.78	$5,128.00	$11,522.02
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $224.89 / $301.70 / $482.87	Facility	52	$224.89	$301.70	$482.87
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $89.96 / $120.69 / $193.15	Facility	53	$89.96	$120.69	$193.15
Aetna Facility/Professional Professional Modifier Low / Median / High Price $328.02 / $472.50 / $931.24	Professional		$328.02	$472.50	$931.24
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $310.05 / $635.90 / $635.90	Professional		$310.05	$635.90	$635.90
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $55.00 / $6,920.96 / $10,512.09	Facility		$55.00	$6,920.96	$10,512.09
Asuris Northwest Health Facility/Professional Facility Modifier 52 Low / Median / High Price $3,614.89 / $6,012.68 / $6,012.68	Facility	52	$3,614.89	$6,012.68	$6,012.68
Asuris Northwest Health Facility/Professional Facility Modifier 53 Low / Median / High Price $903.72 / $1,503.17 / $1,503.17	Facility	53	$903.72	$1,503.17	$1,503.17
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $473.70 / $767.22 / $2,785.65	Professional		$473.70	$767.22	$2,785.65
Cigna Facility/Professional Facility Modifier Low / Median / High Price $500.00 / $870.49 / $3,311.26	Facility		$500.00	$870.49	$3,311.26
Cigna Facility/Professional Professional Modifier Low / Median / High Price $342.15 / $612.62 / $987.33	Professional		$342.15	$612.62	$987.33
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $388.68 / $757.92 / $3,003.60	Facility		$388.68	$757.92	$3,003.60
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $323.52 / $721.50 / $2,230.98	Professional		$323.52	$721.50	$2,230.98
Molina Facility/Professional Professional Modifier Low / Median / High Price $87.30 / $527.94 / $888.43	Professional		$87.30	$527.94	$888.43
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $485.59 / $636.76 / $656.88	Facility		$485.59	$636.76	$656.88
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $439.86 / $447.40 / $1,915.04	Facility		$439.86	$447.40	$1,915.04
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $467.81 / $741.12 / $894.52	Professional		$467.81	$741.12	$894.52
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $4,873.77 / $7,956.97 / $15,220.78	Facility		$4,873.77	$7,956.97	$15,220.78
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $519.49 / $643.60 / $850.95	Professional		$519.49	$643.60	$850.95
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 $364.42 / $575.40 / $949.41	Professional		$364.42	$575.40	$949.41
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $270.55 / $343.73 / $343.73	Professional		$270.55	$343.73	$343.73