Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $315.82 / $2,318.71 / $5,539.00	Facility		$315.82	$2,318.71	$5,539.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $2,559.00 / $3,262.66 / $4,056.00	Facility	50	$2,559.00	$3,262.66	$4,056.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $122.51 / $277.88 / $753.88	Professional		$122.51	$277.88	$753.88
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $171.84 / $760.50 / $1,332.00	Professional	50	$171.84	$760.50	$1,332.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $371.18 / $371.18 / $371.18	Professional		$371.18	$371.18	$371.18
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $442.20 / $2,583.03 / $6,683.07	Facility		$442.20	$2,583.03	$6,683.07
Asuris Northwest Health Facility/Professional Facility Modifier 50 Low / Median / High Price $2,424.63 / $3,874.55 / $7,495.73	Facility	50	$2,424.63	$3,874.55	$7,495.73
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $221.14 / $488.30 / $1,990.16	Professional		$221.14	$488.30	$1,990.16
Asuris Northwest Health Facility/Professional Professional Modifier 50 Low / Median / High Price $317.73 / $787.64 / $1,127.40	Professional	50	$317.73	$787.64	$1,127.40
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 $168.19 / $333.63 / $751.64	Professional		$168.19	$333.63	$751.64
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $169.65 / $328.02 / $840.73	Facility		$169.65	$328.02	$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 $169.65 / $327.58 / $715.68	Professional		$169.65	$327.58	$715.68
Molina Facility/Professional Professional Modifier Low / Median / High Price $63.47 / $352.49 / $624.85	Professional		$63.47	$352.49	$624.85
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $261.51 / $456.94 / $534.66	Facility		$261.51	$456.94	$534.66
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $308.82 / $362.40 / $927.31	Facility		$308.82	$362.40	$927.31
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $217.96 / $364.69 / $660.97	Professional		$217.96	$364.69	$660.97
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 $207.32 / $369.60 / $633.14	Professional		$207.32	$369.60	$633.14
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 $304.92 / $428.34 / $765.65	Professional		$304.92	$428.34	$765.65
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $139.09 / $218.64 / $296.94	Professional		$139.09	$218.64	$296.94