Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $957.66 / $9,368.00 / $20,680.40	Facility		$957.66	$9,368.00	$20,680.40
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $4,930.93 / $18,359.71 / $43,419.97	Facility	50	$4,930.93	$18,359.71	$43,419.97
Aetna Facility/Professional Professional Modifier Low / Median / High Price $454.01 / $716.31 / $1,980.00	Professional		$454.01	$716.31	$1,980.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $409.98 / $614.97 / $1,024.94	Professional		$409.98	$614.97	$1,024.94
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $1,481.16 / $9,558.29 / $26,542.00	Facility		$1,481.16	$9,558.29	$26,542.00
Asuris Northwest Health Facility/Professional Facility Modifier 50 Low / Median / High Price $10,787.19 / $14,706.45 / $28,451.21	Facility	50	$10,787.19	$14,706.45	$28,451.21
Asuris Northwest Health Facility/Professional Facility Modifier AS Low / Median / High Price $544.69 / $905.99 / $905.99	Facility	AS	$544.69	$905.99	$905.99
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $744.17 / $1,243.59 / $4,650.38	Professional		$744.17	$1,243.59	$4,650.38
Cigna Facility/Professional Facility Modifier Low / Median / High Price $883.20 / $1,075.31 / $3,991.53	Facility		$883.20	$1,075.31	$3,991.53
Cigna Facility/Professional Professional Modifier Low / Median / High Price $519.17 / $935.62 / $1,581.25	Professional		$519.17	$935.62	$1,581.25
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $579.00 / $1,095.25 / $3,651.07	Facility		$579.00	$1,095.25	$3,651.07
Kaiser Permanente Facility/Professional Facility Modifier 50 Low / Median / High Price $8,316.01 / $10,887.00 / $26,194.07	Facility	50	$8,316.01	$10,887.00	$26,194.07
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $496.88 / $1,048.17 / $2,689.31	Professional		$496.88	$1,048.17	$2,689.31
Molina Facility/Professional Professional Modifier Low / Median / High Price $96.25 / $604.65 / $1,221.64	Professional		$96.25	$604.65	$1,221.64
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $731.57 / $1,007.68 / $1,059.94	Facility		$731.57	$1,007.68	$1,059.94
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $709.40 / $1,460.91 / $2,583.64	Facility		$709.40	$1,460.91	$2,583.64
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $751.68 / $1,195.36 / $1,442.81	Professional		$751.68	$1,195.36	$1,442.81
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $7,069.92 / $9,804.29 / $18,754.53	Facility		$7,069.92	$9,804.29	$18,754.53
Regence BlueShield Facility/Professional Facility Modifier 50 Low / Median / High Price $10,604.88 / $14,706.45 / $28,131.80	Facility	50	$10,604.88	$14,706.45	$28,131.80
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $837.81 / $1,040.00 / $1,363.63	Professional		$837.81	$1,040.00	$1,363.63
United Facility/Professional Facility Modifier Low / Median / High Price $1,448.97 / $3,129.00 / $7,198.00	Facility		$1,448.97	$3,129.00	$7,198.00
United Facility/Professional Professional Modifier Low / Median / High Price $576.46 / $961.38 / $1,580.43	Professional		$576.46	$961.38	$1,580.43
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $440.05 / $559.84 / $559.84	Professional		$440.05	$559.84	$559.84