Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $377.17 / $697.05 / $13,809.00	Facility		$377.17	$697.05	$13,809.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $1,963.50 / $1,963.50 / $1,979.96	Facility	50	$1,963.50	$1,963.50	$1,979.96
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $282.45 / $371.48 / $514.19	Facility	54	$282.45	$371.48	$514.19
Aetna Facility/Professional Professional Modifier Low / Median / High Price $234.68 / $315.29 / $673.20	Professional		$234.68	$315.29	$673.20
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $306.77 / $416.31 / $622.50	Professional	50	$306.77	$416.31	$622.50
Aetna Facility/Professional Professional Modifier 54 Low / Median / High Price $163.00 / $260.67 / $557.64	Professional	54	$163.00	$260.67	$557.64
Aetna Facility/Professional Professional Modifier 55 Low / Median / High Price $28.94 / $47.29 / $95.09	Professional	55	$28.94	$47.29	$95.09
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $197.75 / $197.75 / $269.87	Professional		$197.75	$197.75	$269.87
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $164.08 / $1,544.02 / $3,151.02	Facility		$164.08	$1,544.02	$3,151.02
Asuris Northwest Health Facility/Professional Facility Modifier 50 Low / Median / High Price $1,816.02 / $2,470.89 / $4,780.18	Facility	50	$1,816.02	$2,470.89	$4,780.18
Asuris Northwest Health Facility/Professional Facility Modifier 54 Low / Median / High Price $371.19 / $645.34 / $645.34	Facility	54	$371.19	$645.34	$645.34
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $320.20 / $522.66 / $4,509.17	Professional		$320.20	$522.66	$4,509.17
Asuris Northwest Health Facility/Professional Professional Modifier 50 Low / Median / High Price $383.67 / $614.63 / $987.00	Professional	50	$383.67	$614.63	$987.00
Asuris Northwest Health Facility/Professional Professional Modifier 54 Low / Median / High Price $357.33 / $438.06 / $438.06	Professional	54	$357.33	$438.06	$438.06
Asuris Northwest Health Facility/Professional Professional Modifier 55 Low / Median / High Price $39.70 / $40.98 / $40.98	Professional	55	$39.70	$40.98	$40.98
Cigna Facility/Professional Facility Modifier Low / Median / High Price $309.52 / $309.52 / $479.00	Facility		$309.52	$309.52	$479.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $244.57 / $389.07 / $737.73	Professional		$244.57	$389.07	$737.73
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $157.91 / $409.50 / $753.62	Facility		$157.91	$409.50	$753.62
Kaiser Permanente Facility/Professional Facility Modifier 50 Low / Median / High Price $1,444.17 / $1,588.70 / $4,299.31	Facility	50	$1,444.17	$1,588.70	$4,299.31
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $158.90 / $409.50 / $695.57	Professional		$158.90	$409.50	$695.57
Molina Facility/Professional Professional Modifier Low / Median / High Price $55.96 / $296.15 / $548.27	Professional		$55.96	$296.15	$548.27
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $334.95 / $468.33 / $603.70	Facility		$334.95	$468.33	$603.70
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $164.08 / $325.25 / $334.07	Facility		$164.08	$325.25	$334.07
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $327.73 / $478.13 / $626.24	Professional		$327.73	$478.13	$626.24
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $1,195.59 / $1,646.32 / $3,151.02	Facility		$1,195.59	$1,646.32	$3,151.02
Regence BlueShield Facility/Professional Facility Modifier 50 Low / Median / High Price $1,793.40 / $2,469.48 / $4,726.53	Facility	50	$1,793.40	$2,469.48	$4,726.53
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $274.43 / $454.04 / $633.04	Professional		$274.43	$454.04	$633.04
United Facility/Professional Facility Modifier Low / Median / High Price $332.00 / $648.00 / $4,611.00	Facility		$332.00	$648.00	$4,611.00
United Facility/Professional Professional Modifier Low / Median / High Price $314.20 / $420.98 / $689.70	Professional		$314.20	$420.98	$689.70