Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,250.30 / $2,854.50 / $18,711.00	Facility		$1,250.30	$2,854.50	$18,711.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $937.73 / $1,337.12 / $1,601.70	Facility	54	$937.73	$1,337.12	$1,601.70
Aetna Facility/Professional Professional Modifier Low / Median / High Price $599.08 / $868.66 / $1,841.43	Professional		$599.08	$868.66	$1,841.43
Aetna Facility/Professional Professional Modifier 55 Low / Median / High Price $95.44 / $187.55 / $345.41	Professional	55	$95.44	$187.55	$345.41
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $1,664.52 / $1,664.52 / $1,664.52	Professional		$1,664.52	$1,664.52	$1,664.52
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $2,031.87 / $11,522.14 / $22,040.55	Facility		$2,031.87	$11,522.14	$22,040.55
Asuris Northwest Health Facility/Professional Facility Modifier 54 Low / Median / High Price $4,738.57 / $7,881.75 / $7,881.75	Facility	54	$4,738.57	$7,881.75	$7,881.75
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $1,131.16 / $2,055.71 / $7,004.55	Professional		$1,131.16	$2,055.71	$7,004.55
Asuris Northwest Health Facility/Professional Professional Modifier 55 Low / Median / High Price $157.16 / $162.21 / $162.21	Professional	55	$157.16	$162.21	$162.21
Cigna Facility/Professional Facility Modifier Low / Median / High Price $479.00 / $479.00 / $4,960.67	Facility		$479.00	$479.00	$4,960.67
Cigna Facility/Professional Professional Modifier Low / Median / High Price $762.87 / $1,283.32 / $2,582.37	Professional		$762.87	$1,283.32	$2,582.37
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $894.43 / $1,864.94 / $4,350.34	Facility		$894.43	$1,864.94	$4,350.34
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $894.43 / $1,862.51 / $3,678.65	Professional		$894.43	$1,862.51	$3,678.65
Molina Facility/Professional Professional Modifier Low / Median / High Price $78.85 / $465.93 / $1,605.76	Professional		$78.85	$465.93	$1,605.76
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,038.80 / $1,434.80 / $1,644.18	Facility		$1,038.80	$1,434.80	$1,644.18
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,097.17 / $1,097.17 / $1,121.48	Facility		$1,097.17	$1,097.17	$1,121.48
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,154.35 / $1,855.50 / $2,226.02	Professional		$1,154.35	$1,855.50	$2,226.02
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $7,600.42 / $11,522.14 / $22,040.55	Facility		$7,600.42	$11,522.14	$22,040.55
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $1,118.96 / $1,616.19 / $2,270.88	Professional		$1,118.96	$1,616.19	$2,270.88
United Facility/Professional Facility Modifier Low / Median / High Price $1,224.00 / $1,862.00 / $10,522.00	Facility		$1,224.00	$1,862.00	$10,522.00
United Facility/Professional Professional Modifier Low / Median / High Price $850.72 / $1,221.55 / $2,198.79	Professional		$850.72	$1,221.55	$2,198.79