Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $100.34 / $392.64 / $13,750.00	Facility		$100.34	$392.64	$13,750.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $3,223.50 / $3,223.50 / $3,223.50	Facility	50	$3,223.50	$3,223.50	$3,223.50
Aetna Facility/Professional Professional Modifier Low / Median / High Price $68.02 / $127.39 / $241.42	Professional		$68.02	$127.39	$241.42
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $200.47 / $200.47 / $200.47	Professional		$200.47	$200.47	$200.47
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $292.89 / $2,583.03 / $11,500.00	Facility		$292.89	$2,583.03	$11,500.00
Asuris Northwest Health Facility/Professional Facility Modifier 50 Low / Median / High Price $2,799.32 / $3,874.55 / $7,495.73	Facility	50	$2,799.32	$3,874.55	$7,495.73
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $91.17 / $155.41 / $1,087.00	Professional		$91.17	$155.41	$1,087.00
Asuris Northwest Health Facility/Professional Professional Modifier 50 Low / Median / High Price $159.99 / $290.37 / $316.50	Professional	50	$159.99	$290.37	$316.50
Cigna Facility/Professional Facility Modifier Low / Median / High Price $466.83 / $568.48 / $1,132.06	Facility		$466.83	$568.48	$1,132.06
Cigna Facility/Professional Professional Modifier Low / Median / High Price $85.33 / $155.22 / $283.10	Professional		$85.33	$155.22	$283.10
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $102.96 / $194.19 / $840.73	Facility		$102.96	$194.19	$840.73
Kaiser Permanente Facility/Professional Facility Modifier 50 Low / Median / High Price $1,907.75 / $2,550.75 / $5,846.21	Facility	50	$1,907.75	$2,550.75	$5,846.21
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $102.96 / $188.92 / $491.14	Professional		$102.96	$188.92	$491.14
Molina Facility/Professional Professional Modifier Low / Median / High Price $27.14 / $151.02 / $268.41	Professional		$27.14	$151.02	$268.41
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $139.80 / $191.51 / $261.30	Facility		$139.80	$191.51	$261.30
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $133.18 / $134.82 / $927.31	Facility		$133.18	$134.82	$927.31
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $93.68 / $142.58 / $245.88	Professional		$93.68	$142.58	$245.88
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $1,674.98 / $2,581.55 / $4,941.05	Facility		$1,674.98	$2,581.55	$4,941.05
Regence BlueShield Facility/Professional Facility Modifier 50 Low / Median / High Price $2,512.46 / $3,872.33 / $7,411.58	Facility	50	$2,512.46	$3,872.33	$7,411.58
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $87.24 / $135.83 / $236.46	Professional		$87.24	$135.83	$236.46
United Facility/Professional Facility Modifier Low / Median / High Price $472.00 / $938.00 / $4,611.00	Facility		$472.00	$938.00	$4,611.00
United Facility/Professional Professional Modifier Low / Median / High Price $113.08 / $197.27 / $284.83	Professional		$113.08	$197.27	$284.83
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $57.84 / $80.89 / $108.36	Professional		$57.84	$80.89	$108.36