Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $262.00 / $2,948.19 / $8,281.61	Facility		$262.00	$2,948.19	$8,281.61
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $71.76 / $227.73 / $423.52	Facility	52	$71.76	$227.73	$423.52
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $28.70 / $62.77 / $159.43	Facility	53	$28.70	$62.77	$159.43
Aetna Facility/Professional Professional Modifier Low / Median / High Price $97.14 / $282.79 / $651.29	Professional		$97.14	$282.79	$651.29
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $93.09 / $185.16 / $532.26	Professional		$93.09	$185.16	$532.26
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $55.00 / $1,570.62 / $3,393.78	Facility		$55.00	$1,570.62	$3,393.78
Asuris Northwest Health Facility/Professional Facility Modifier 52 Low / Median / High Price $217.12 / $381.48 / $381.48	Facility	52	$217.12	$381.48	$381.48
Asuris Northwest Health Facility/Professional Facility Modifier 53 Low / Median / High Price $54.28 / $95.37 / $95.37	Facility	53	$54.28	$95.37	$95.37
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $169.29 / $507.31 / $2,156.80	Professional		$169.29	$507.31	$2,156.80
Cigna Facility/Professional Facility Modifier Low / Median / High Price $500.00 / $715.69 / $1,192.33	Facility		$500.00	$715.69	$1,192.33
Cigna Facility/Professional Professional Modifier Low / Median / High Price $141.56 / $316.16 / $822.55	Professional		$141.56	$316.16	$822.55
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $149.76 / $404.55 / $900.39	Facility		$149.76	$404.55	$900.39
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $146.11 / $315.00 / $843.57	Professional		$146.11	$315.00	$843.57
Molina Facility/Professional Professional Modifier Low / Median / High Price $71.48 / $436.72 / $742.68	Professional		$71.48	$436.72	$742.68
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $341.54 / $560.79 / $609.96	Facility		$341.54	$560.79	$609.96
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $398.05 / $406.34 / $666.60	Facility		$398.05	$406.34	$666.60
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $172.75 / $349.19 / $765.70	Professional		$172.75	$349.19	$765.70
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $1,665.80 / $2,568.87 / $4,913.96	Facility		$1,665.80	$2,568.87	$4,913.96
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $175.38 / $407.92 / $674.15	Professional		$175.38	$407.92	$674.15
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 $325.27 / $513.61 / $854.46	Professional		$325.27	$513.61	$854.46
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $110.48 / $236.59 / $324.37	Professional		$110.48	$236.59	$324.37