Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $437.51 / $4,497.00 / $9,286.62	Facility		$437.51	$4,497.00	$9,286.62
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $868.69 / $7,111.06 / $9,703.00	Facility	50	$868.69	$7,111.06	$9,703.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $208.71 / $451.79 / $1,172.24	Professional		$208.71	$451.79	$1,172.24
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $293.02 / $735.63 / $2,799.00	Professional	50	$293.02	$735.63	$2,799.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $183.56 / $256.56 / $1,533.63	Professional		$183.56	$256.56	$1,533.63
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $275.33 / $492.60 / $1,294.68	Professional	50	$275.33	$492.60	$1,294.68
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $606.11 / $5,350.20 / $12,100.72	Facility		$606.11	$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 $348.11 / $803.56 / $3,287.44	Professional		$348.11	$803.56	$3,287.44
Asuris Northwest Health Facility/Professional Professional Modifier 50 Low / Median / High Price $565.49 / $583.59 / $1,335.00	Professional	50	$565.49	$583.59	$1,335.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $714.97 / $870.49 / $2,190.81	Facility		$714.97	$870.49	$2,190.81
Cigna Facility/Professional Professional Modifier Low / Median / High Price $283.70 / $528.32 / $1,251.07	Professional		$283.70	$528.32	$1,251.07
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $280.95 / $560.87 / $1,644.07	Facility		$280.95	$560.87	$1,644.07
Kaiser Permanente Facility/Professional Facility Modifier 50 Low / Median / High Price $3,293.47 / $5,945.69 / $14,305.29	Facility	50	$3,293.47	$5,945.69	$14,305.29
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $280.95 / $549.17 / $1,360.21	Professional		$280.95	$549.17	$1,360.21
Molina Facility/Professional Professional Modifier Low / Median / High Price $37.44 / $362.24 / $953.68	Professional		$37.44	$362.24	$953.68
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $428.79 / $791.27 / $888.42	Facility		$428.79	$791.27	$888.42
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $598.07 / $605.98 / $1,795.87	Facility		$598.07	$605.98	$1,795.87
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $330.45 / $580.13 / $1,093.56	Professional		$330.45	$580.13	$1,093.56
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 $304.79 / $617.53 / $1,026.89	Professional		$304.79	$617.53	$1,026.89
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 $496.02 / $727.10 / $1,255.90	Professional		$496.02	$727.10	$1,255.90
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $205.25 / $358.88 / $490.56	Professional		$205.25	$358.88	$490.56