Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $145.82 / $935.86 / $6,096.00	Facility		$145.82	$935.86	$6,096.00
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $50.84 / $146.65 / $235.69	Facility	52	$50.84	$146.65	$235.69
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $20.32 / $58.66 / $94.27	Facility	53	$20.32	$58.66	$94.27
Aetna Facility/Professional Professional Modifier Low / Median / High Price $101.67 / $233.40 / $543.83	Professional		$101.67	$233.40	$543.83
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $50.84 / $103.14 / $225.02	Professional	52	$50.84	$103.14	$225.02
Aetna Facility/Professional Professional Modifier 53 Low / Median / High Price $20.32 / $41.26 / $90.01	Professional	53	$20.32	$41.26	$90.01
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $137.63 / $137.63 / $137.63	Professional		$137.63	$137.63	$137.63
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $407.55 / $1,935.85 / $11,500.00	Facility		$407.55	$1,935.85	$11,500.00
Asuris Northwest Health Facility/Professional Facility Modifier 52 Low / Median / High Price $163.50 / $289.45 / $289.45	Facility	52	$163.50	$289.45	$289.45
Asuris Northwest Health Facility/Professional Facility Modifier 53 Low / Median / High Price $40.86 / $72.36 / $72.36	Facility	53	$40.86	$72.36	$72.36
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $145.63 / $443.44 / $1,775.04	Professional		$145.63	$443.44	$1,775.04
Cigna Facility/Professional Facility Modifier Low / Median / High Price $449.17 / $449.17 / $748.32	Facility		$449.17	$449.17	$748.32
Cigna Facility/Professional Professional Modifier Low / Median / High Price $127.96 / $239.46 / $731.34	Professional		$127.96	$239.46	$731.34
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $136.27 / $290.55 / $656.24	Facility		$136.27	$290.55	$656.24
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $136.27 / $273.12 / $587.99	Professional		$136.27	$273.12	$587.99
Molina Facility/Professional Professional Modifier Low / Median / High Price $60.34 / $388.60 / $636.08	Professional		$60.34	$388.60	$636.08
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $217.34 / $379.90 / $481.73	Facility		$217.34	$379.90	$481.73
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $306.32 / $328.58 / $331.14	Facility		$306.32	$328.58	$331.14
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $142.06 / $264.63 / $602.69	Professional		$142.06	$264.63	$602.69
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $1,412.56 / $1,934.75 / $3,703.07	Facility		$1,412.56	$1,934.75	$3,703.07
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $127.09 / $287.06 / $556.51	Professional		$127.09	$287.06	$556.51
United Facility/Professional Facility Modifier Low / Median / High Price $591.00 / $1,302.00 / $4,611.00	Facility		$591.00	$1,302.00	$4,611.00
United Facility/Professional Professional Modifier Low / Median / High Price $269.55 / $491.64 / $684.96	Professional		$269.55	$491.64	$684.96