Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $471.91 / $5,116.62 / $8,759.87	Facility		$471.91	$5,116.62	$8,759.87
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $5,309.49 / $8,746.48 / $9,645.00	Facility	50	$5,309.49	$8,746.48	$9,645.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $213.03 / $440.54 / $1,132.58	Professional		$213.03	$440.54	$1,132.58
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $315.20 / $595.62 / $2,780.00	Professional	50	$315.20	$595.62	$2,780.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $183.63 / $183.63 / $190.77	Professional		$183.63	$183.63	$190.77
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $522.41 / $522.41 / $522.41	Professional	50	$522.41	$522.41	$522.41
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $600.96 / $5,350.20 / $12,100.72	Facility		$600.96	$5,350.20	$12,100.72
Asuris Northwest Health Facility/Professional Facility Modifier 50 Low / Median / High Price $5,971.22 / $8,207.42 / $15,878.12	Facility	50	$5,971.22	$8,207.42	$15,878.12
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $347.49 / $796.89 / $3,260.40	Professional		$347.49	$796.89	$3,260.40
Asuris Northwest Health Facility/Professional Professional Modifier 50 Low / Median / High Price $565.01 / $583.11 / $1,324.50	Professional	50	$565.01	$583.11	$1,324.50
Cigna Facility/Professional Facility Modifier Low / Median / High Price $500.00 / $870.49 / $2,190.81	Facility		$500.00	$870.49	$2,190.81
Cigna Facility/Professional Professional Modifier Low / Median / High Price $287.68 / $531.90 / $1,240.55	Professional		$287.68	$531.90	$1,240.55
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $285.33 / $568.79 / $1,644.07	Facility		$285.33	$568.79	$1,644.07
Kaiser Permanente Facility/Professional Facility Modifier 50 Low / Median / High Price $1,908.48 / $5,945.69 / $14,305.29	Facility	50	$1,908.48	$5,945.69	$14,305.29
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $285.33 / $559.19 / $1,360.21	Professional		$285.33	$559.19	$1,360.21
Molina Facility/Professional Professional Modifier Low / Median / High Price $45.75 / $439.47 / $937.77	Professional		$45.75	$439.47	$937.77
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $446.43 / $799.50 / $881.05	Facility		$446.43	$799.50	$881.05
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $598.07 / $600.67 / $1,795.87	Facility		$598.07	$600.67	$1,795.87
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $329.88 / $580.95 / $1,091.89	Professional		$329.88	$580.95	$1,091.89
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $3,548.09 / $5,468.48 / $10,466.57	Facility		$3,548.09	$5,468.48	$10,466.57
Regence BlueShield Facility/Professional Facility Modifier 50 Low / Median / High Price $5,322.14 / $8,202.71 / $15,699.86	Facility	50	$5,322.14	$8,202.71	$15,699.86
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $304.25 / $612.61 / $1,036.81	Professional		$304.25	$612.61	$1,036.81
United Facility/Professional Facility Modifier Low / Median / High Price $1,547.00 / $2,408.00 / $10,522.00	Facility		$1,547.00	$2,408.00	$10,522.00
United Facility/Professional Professional Modifier Low / Median / High Price $513.41 / $730.96 / $1,244.49	Professional		$513.41	$730.96	$1,244.49
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $205.13 / $355.85 / $486.11	Professional		$205.13	$355.85	$486.11