Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $627.71 / $13,746.00 / $31,602.88	Facility		$627.71	$13,746.00	$31,602.88
Aetna Facility/Professional Facility Modifier 22 Low / Median / High Price $474.27 / $474.27 / $474.27	Facility	22	$474.27	$474.27	$474.27
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $5,645.31 / $24,747.07 / $42,125.46	Facility	50	$5,645.31	$24,747.07	$42,125.46
Aetna Facility/Professional Professional Modifier Low / Median / High Price $361.88 / $594.54 / $1,668.74	Professional		$361.88	$594.54	$1,668.74
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $425.75 / $787.64 / $876.85	Professional		$425.75	$787.64	$876.85
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $3,598.26 / $16,223.75 / $26,542.00	Facility		$3,598.26	$16,223.75	$26,542.00
Asuris Northwest Health Facility/Professional Facility Modifier 50 Low / Median / High Price $16,820.81 / $24,527.22 / $47,450.52	Facility	50	$16,820.81	$24,527.22	$47,450.52
Asuris Northwest Health Facility/Professional Facility Modifier AS Low / Median / High Price $924.53 / $1,537.78 / $1,537.78	Facility	AS	$924.53	$1,537.78	$1,537.78
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $604.20 / $989.17 / $3,959.35	Professional		$604.20	$989.17	$3,959.35
Cigna Facility/Professional Facility Modifier Low / Median / High Price $883.20 / $1,075.31 / $6,775.01	Facility		$883.20	$1,075.31	$6,775.01
Cigna Facility/Professional Professional Modifier Low / Median / High Price $450.07 / $777.21 / $1,313.00	Professional		$450.07	$777.21	$1,313.00
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $480.00 / $902.86 / $6,197.13	Facility		$480.00	$902.86	$6,197.13
Kaiser Permanente Facility/Professional Facility Modifier 50 Low / Median / High Price $12,028.17 / $15,969.29 / $38,422.04	Facility	50	$12,028.17	$15,969.29	$38,422.04
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $410.52 / $863.98 / $4,564.68	Professional		$410.52	$863.98	$4,564.68
Molina Facility/Professional Professional Modifier Low / Median / High Price $51.61 / $354.61 / $979.99	Professional		$51.61	$354.61	$979.99
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $607.11 / $828.79 / $879.04	Facility		$607.11	$828.79	$879.04
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $586.64 / $2,010.99 / $3,875.03	Facility		$586.64	$2,010.99	$3,875.03
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $621.60 / $989.17 / $1,193.92	Professional		$621.60	$989.17	$1,193.92
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $10,603.20 / $16,351.48 / $31,278.54	Facility		$10,603.20	$16,351.48	$31,278.54
Regence BlueShield Facility/Professional Facility Modifier 50 Low / Median / High Price $15,904.80 / $24,527.22 / $46,917.81	Facility	50	$15,904.80	$24,527.22	$46,917.81
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $692.83 / $862.51 / $1,127.01	Professional		$692.83	$862.51	$1,127.01
United Facility/Professional Facility Modifier Low / Median / High Price $1,900.00 / $4,686.00 / $19,271.00	Facility		$1,900.00	$4,686.00	$19,271.00
United Facility/Professional Professional Modifier Low / Median / High Price $470.83 / $737.50 / $1,255.14	Professional		$470.83	$737.50	$1,255.14
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $364.96 / $466.41 / $466.41	Professional		$364.96	$466.41	$466.41