Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $498.54 / $1,517.14 / $14,464.32	Facility		$498.54	$1,517.14	$14,464.32
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $2,750.93 / $2,750.93 / $2,750.93	Facility	50	$2,750.93	$2,750.93	$2,750.93
Aetna Facility/Professional Professional Modifier Low / Median / High Price $385.26 / $454.32 / $1,154.64	Professional		$385.26	$454.32	$1,154.64
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $639.87 / $639.87 / $3,609.00	Professional	50	$639.87	$639.87	$3,609.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $285.85 / $437.51 / $495.91	Professional		$285.85	$437.51	$495.91
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $237.85 / $1,646.32 / $3,151.02	Facility		$237.85	$1,646.32	$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 Professional Modifier Low / Median / High Price $326.17 / $522.44 / $2,946.00	Professional		$326.17	$522.44	$2,946.00
Asuris Northwest Health Facility/Professional Professional Modifier 50 Low / Median / High Price $404.46 / $722.00 / $1,071.00	Professional	50	$404.46	$722.00	$1,071.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $344.02 / $344.02 / $479.00	Facility		$344.02	$344.02	$479.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $283.11 / $627.86 / $892.90	Professional		$283.11	$627.86	$892.90
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $175.51 / $638.39 / $1,254.71	Facility		$175.51	$638.39	$1,254.71
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 $176.60 / $641.26 / $1,231.93	Professional		$176.60	$641.26	$1,231.93
Molina Facility/Professional Professional Modifier Low / Median / High Price $58.47 / $334.69 / $577.38	Professional		$58.47	$334.69	$577.38
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $396.86 / $678.78 / $1,022.42	Facility		$396.86	$678.78	$1,022.42
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $237.85 / $319.82 / $331.78	Facility		$237.85	$319.82	$331.78
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $331.78 / $504.25 / $717.18	Professional		$331.78	$504.25	$717.18
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 $289.67 / $464.83 / $1,096.13	Professional		$289.67	$464.83	$1,096.13
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 $469.79 / $693.23 / $1,189.57	Professional		$469.79	$693.23	$1,189.57