Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $276.55 / $3,595.20 / $8,890.89	Facility		$276.55	$3,595.20	$8,890.89
Aetna Facility/Professional Professional Modifier Low / Median / High Price $152.93 / $409.89 / $1,059.69	Professional		$152.93	$409.89	$1,059.69
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $209.97 / $209.97 / $209.97	Professional		$209.97	$209.97	$209.97
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $1,020.11 / $4,594.55 / $11,887.47	Facility		$1,020.11	$4,594.55	$11,887.47
Asuris Northwest Health Facility/Professional Facility Modifier 50 Low / Median / High Price $5,034.33 / $6,891.83 / $13,332.98	Facility	50	$5,034.33	$6,891.83	$13,332.98
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $225.54 / $967.02 / $3,753.52	Professional		$225.54	$967.02	$3,753.52
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,007.00 / $1,007.00 / $1,677.65	Facility		$1,007.00	$1,007.00	$1,677.65
Cigna Facility/Professional Professional Modifier Low / Median / High Price $200.75 / $536.80 / $1,552.69	Professional		$200.75	$536.80	$1,552.69
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $197.34 / $653.57 / $1,540.77	Facility		$197.34	$653.57	$1,540.77
Kaiser Permanente Facility/Professional Facility Modifier 50 Low / Median / High Price $2,447.42 / $4,702.87 / $11,315.07	Facility	50	$2,447.42	$4,702.87	$11,315.07
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $197.34 / $532.58 / $1,471.24	Professional		$197.34	$532.58	$1,471.24
Molina Facility/Professional Professional Modifier Low / Median / High Price $121.19 / $773.40 / $1,276.17	Professional		$121.19	$773.40	$1,276.17
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $251.25 / $977.31 / $1,110.19	Facility		$251.25	$977.31	$1,110.19
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $625.69 / $694.64 / $721.63	Facility		$625.69	$694.64	$721.63
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $213.79 / $413.63 / $1,346.25	Professional		$213.79	$413.63	$1,346.25
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $2,979.36 / $4,591.92 / $8,788.86	Facility		$2,979.36	$4,591.92	$8,788.86
Regence BlueShield Facility/Professional Facility Modifier 50 Low / Median / High Price $4,469.04 / $6,887.88 / $13,183.29	Facility	50	$4,469.04	$6,887.88	$13,183.29
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $199.78 / $406.56 / $1,176.48	Professional		$199.78	$406.56	$1,176.48
United Facility/Professional Facility Modifier Low / Median / High Price $879.00 / $1,689.00 / $7,385.00	Facility		$879.00	$1,689.00	$7,385.00
United Facility/Professional Professional Modifier Low / Median / High Price $649.74 / $1,097.13 / $1,578.55	Professional		$649.74	$1,097.13	$1,578.55