Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $998.76 / $6,530.29 / $16,924.31	Facility		$998.76	$6,530.29	$16,924.31
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $9,313.20 / $9,313.20 / $9,313.20	Facility	50	$9,313.20	$9,313.20	$9,313.20
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $163.69 / $247.56 / $365.06	Facility	53	$163.69	$247.56	$365.06
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $613.85 / $928.36 / $1,368.98	Facility	54	$613.85	$928.36	$1,368.98
Aetna Facility/Professional Facility Modifier 55 Low / Median / High Price $122.77 / $185.67 / $273.80	Facility	55	$122.77	$185.67	$273.80
Aetna Facility/Professional Professional Modifier Low / Median / High Price $525.95 / $818.46 / $3,176.04	Professional		$525.95	$818.46	$3,176.04
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $4,329.68 / $4,329.68 / $4,329.68	Professional	50	$4,329.68	$4,329.68	$4,329.68
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $253.84 / $409.23 / $829.98	Professional	52	$253.84	$409.23	$829.98
Aetna Facility/Professional Professional Modifier 54 Low / Median / High Price $380.75 / $613.85 / $1,368.98	Professional	54	$380.75	$613.85	$1,368.98
Aetna Facility/Professional Professional Modifier 55 Low / Median / High Price $63.49 / $122.77 / $240.28	Professional	55	$63.49	$122.77	$240.28
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $716.26 / $997.45 / $1,087.65	Professional		$716.26	$997.45	$1,087.65
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $1,126.18 / $6,603.99 / $14,605.02	Facility		$1,126.18	$6,603.99	$14,605.02
Asuris Northwest Health Facility/Professional Facility Modifier 50 Low / Median / High Price $7,554.80 / $9,905.99 / $19,164.18	Facility	50	$7,554.80	$9,905.99	$19,164.18
Asuris Northwest Health Facility/Professional Facility Modifier 53 Low / Median / High Price $784.99 / $1,305.69 / $1,305.69	Facility	53	$784.99	$1,305.69	$1,305.69
Asuris Northwest Health Facility/Professional Facility Modifier 54 Low / Median / High Price $2,747.48 / $4,569.92 / $4,569.92	Facility	54	$2,747.48	$4,569.92	$4,569.92
Asuris Northwest Health Facility/Professional Facility Modifier 55 Low / Median / High Price $588.75 / $979.27 / $979.27	Facility	55	$588.75	$979.27	$979.27
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $745.13 / $1,351.73 / $6,076.05	Professional		$745.13	$1,351.73	$6,076.05
Asuris Northwest Health Facility/Professional Professional Modifier 50 Low / Median / High Price $1,288.61 / $1,624.85 / $2,377.50	Professional	50	$1,288.61	$1,624.85	$2,377.50
Asuris Northwest Health Facility/Professional Professional Modifier 54 Low / Median / High Price $447.08 / $839.69 / $866.58	Professional	54	$447.08	$839.69	$866.58
Asuris Northwest Health Facility/Professional Professional Modifier 55 Low / Median / High Price $209.92 / $209.92 / $216.65	Professional	55	$209.92	$209.92	$216.65
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,398.00 / $1,398.00 / $2,876.24	Facility		$1,398.00	$1,398.00	$2,876.24
Cigna Facility/Professional Professional Modifier Low / Median / High Price $600.97 / $982.77 / $1,671.18	Professional		$600.97	$982.77	$1,671.18
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $801.96 / $1,339.88 / $2,522.36	Facility		$801.96	$1,339.88	$2,522.36
Kaiser Permanente Facility/Professional Facility Modifier 50 Low / Median / High Price $5,875.62 / $6,463.64 / $16,692.80	Facility	50	$5,875.62	$6,463.64	$16,692.80
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $801.96 / $1,313.25 / $2,132.91	Professional		$801.96	$1,313.25	$2,132.91
Molina Facility/Professional Professional Modifier Low / Median / High Price $77.42 / $312.28 / $1,036.56	Professional		$77.42	$312.28	$1,036.56
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $886.48 / $1,059.83 / $1,258.93	Facility		$886.48	$1,059.83	$1,258.93
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $713.02 / $713.02 / $1,077.93	Facility		$713.02	$713.02	$1,077.93
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $759.23 / $1,216.68 / $1,464.06	Professional		$759.23	$1,216.68	$1,464.06
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $4,818.83 / $6,600.21 / $12,632.68	Facility		$4,818.83	$6,600.21	$12,632.68
Regence BlueShield Facility/Professional Facility Modifier 50 Low / Median / High Price $7,228.25 / $9,900.32 / $18,949.02	Facility	50	$7,228.25	$9,900.32	$18,949.02
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $727.19 / $1,061.05 / $1,555.38	Professional		$727.19	$1,061.05	$1,555.38
United Facility/Professional Facility Modifier Low / Median / High Price $1,220.00 / $2,136.00 / $10,522.00	Facility		$1,220.00	$2,136.00	$10,522.00
United Facility/Professional Professional Modifier Low / Median / High Price $693.97 / $968.00 / $1,526.84	Professional		$693.97	$968.00	$1,526.84