Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $166.01 / $2,769.52 / $5,391.72	Facility		$166.01	$2,769.52	$5,391.72
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $808.53 / $3,993.72 / $6,340.00	Facility	50	$808.53	$3,993.72	$6,340.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $87.29 / $178.78 / $474.60	Professional		$87.29	$178.78	$474.60
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $82.96 / $284.52 / $1,023.11	Professional	50	$82.96	$284.52	$1,023.11
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $106.25 / $235.99 / $352.24	Professional		$106.25	$235.99	$352.24
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $130.37 / $269.54 / $528.36	Professional	50	$130.37	$269.54	$528.36
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $308.82 / $2,525.71 / $5,712.49	Facility		$308.82	$2,525.71	$5,712.49
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 $151.19 / $299.31 / $776.25	Professional		$151.19	$299.31	$776.25
Asuris Northwest Health Facility/Professional Professional Modifier 50 Low / Median / High Price $266.00 / $527.97 / $537.00	Professional	50	$266.00	$527.97	$537.00
Asuris Northwest Health Facility/Professional Professional Modifier 80 Low / Median / High Price $28.37 / $29.28 / $56.32	Professional	80	$28.37	$29.28	$56.32
Cigna Facility/Professional Facility Modifier Low / Median / High Price $500.00 / $870.49 / $1,132.06	Facility		$500.00	$870.49	$1,132.06
Cigna Facility/Professional Professional Modifier Low / Median / High Price $117.24 / $234.52 / $493.56	Professional		$117.24	$234.52	$493.56
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $119.62 / $228.93 / $840.73	Facility		$119.62	$228.93	$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 $119.62 / $228.09 / $573.82	Professional		$119.62	$228.09	$573.82
Molina Facility/Professional Professional Modifier Low / Median / High Price $54.22 / $302.18 / $536.42	Professional		$54.22	$302.18	$536.42
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $175.45 / $328.22 / $357.11	Facility		$175.45	$328.22	$357.11
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $236.47 / $243.58 / $927.31	Facility		$236.47	$243.58	$927.31
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $149.28 / $244.92 / $439.25	Professional		$149.28	$244.92	$439.25
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 $143.78 / $241.16 / $429.95	Professional		$143.78	$241.16	$429.95
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 $211.99 / $321.33 / $500.66	Professional		$211.99	$321.33	$500.66
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $97.13 / $146.87 / $199.34	Professional		$97.13	$146.87	$199.34