Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $516.88 / $888.95 / $11,522.02	Facility		$516.88	$888.95	$11,522.02
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $1,983.00 / $1,983.00 / $2,183.40	Facility	50	$1,983.00	$1,983.00	$2,183.40
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $358.13 / $517.80 / $666.71	Facility	54	$358.13	$517.80	$666.71
Aetna Facility/Professional Facility Modifier 55 Low / Median / High Price $71.63 / $103.56 / $133.34	Facility	55	$71.63	$103.56	$133.34
Aetna Facility/Professional Professional Modifier Low / Median / High Price $260.42 / $365.06 / $808.42	Professional		$260.42	$365.06	$808.42
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $333.54 / $493.94 / $1,425.00	Professional	50	$333.54	$493.94	$1,425.00
Aetna Facility/Professional Professional Modifier 54 Low / Median / High Price $201.86 / $358.13 / $706.61	Professional	54	$201.86	$358.13	$706.61
Aetna Facility/Professional Professional Modifier 55 Low / Median / High Price $40.36 / $71.63 / $137.01	Professional	55	$40.36	$71.63	$137.01
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $253.85 / $380.78 / $680.32	Professional		$253.85	$380.78	$680.32
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $456.09 / $1,697.93 / $4,261.93	Facility		$456.09	$1,697.93	$4,261.93
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 $564.01 / $979.13 / $979.13	Facility	54	$564.01	$979.13	$979.13
Asuris Northwest Health Facility/Professional Facility Modifier 55 Low / Median / High Price $120.86 / $209.81 / $209.81	Facility	55	$120.86	$209.81	$209.81
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $450.45 / $778.22 / $2,648.63	Professional		$450.45	$778.22	$2,648.63
Asuris Northwest Health Facility/Professional Professional Modifier 50 Low / Median / High Price $675.47 / $958.98 / $1,420.50	Professional	50	$675.47	$958.98	$1,420.50
Asuris Northwest Health Facility/Professional Professional Modifier 54 Low / Median / High Price $575.39 / $593.80 / $593.80	Professional	54	$575.39	$593.80	$593.80
Asuris Northwest Health Facility/Professional Professional Modifier 55 Low / Median / High Price $61.74 / $61.74 / $63.93	Professional	55	$61.74	$61.74	$63.93
Cigna Facility/Professional Facility Modifier Low / Median / High Price $642.00 / $642.00 / $697.61	Facility		$642.00	$642.00	$697.61
Cigna Facility/Professional Professional Modifier Low / Median / High Price $314.11 / $530.46 / $1,027.11	Professional		$314.11	$530.46	$1,027.11
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $324.98 / $461.57 / $831.19	Facility		$324.98	$461.57	$831.19
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 $325.56 / $480.68 / $839.29	Professional		$325.56	$480.68	$839.29
Molina Facility/Professional Professional Modifier Low / Median / High Price $35.67 / $158.62 / $621.92	Professional		$35.67	$158.62	$621.92
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $401.74 / $615.26 / $668.66	Facility		$401.74	$615.26	$668.66
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $276.02 / $441.68 / $456.09	Facility		$276.02	$441.68	$456.09
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $456.09 / $708.76 / $870.75	Professional		$456.09	$708.76	$870.75
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 $417.65 / $640.28 / $857.12	Professional		$417.65	$640.28	$857.12
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 $376.00 / $526.40 / $930.59	Professional		$376.00	$526.40	$930.59