Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $272.76 / $644.24 / $17,100.00	Facility		$272.76	$644.24	$17,100.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $130.50 / $221.12 / $415.68	Professional		$130.50	$221.12	$415.68
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $301.57 / $301.57 / $301.57	Professional		$301.57	$301.57	$301.57
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $185.62 / $6,207.20 / $12,667.56	Facility		$185.62	$6,207.20	$12,667.56
Asuris Northwest Health Facility/Professional Facility Modifier 50 Low / Median / High Price $6,634.41 / $9,933.33 / $19,217.09	Facility	50	$6,634.41	$9,933.33	$19,217.09
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $263.83 / $484.98 / $2,029.28	Professional		$263.83	$484.98	$2,029.28
Asuris Northwest Health Facility/Professional Professional Modifier 50 Low / Median / High Price $354.71 / $651.00 / $781.50	Professional	50	$354.71	$651.00	$781.50
Cigna Facility/Professional Facility Modifier Low / Median / High Price $383.08 / $383.08 / $479.00	Facility		$383.08	$383.08	$479.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $174.39 / $310.32 / $668.34	Professional		$174.39	$310.32	$668.34
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $178.45 / $285.04 / $592.13	Facility		$178.45	$285.04	$592.13
Kaiser Permanente Facility/Professional Facility Modifier 50 Low / Median / High Price $5,752.58 / $6,328.28 / $15,568.54	Facility	50	$5,752.58	$6,328.28	$15,568.54
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $178.50 / $308.44 / $571.44	Professional		$178.50	$308.44	$571.44
Molina Facility/Professional Professional Modifier Low / Median / High Price $35.67 / $185.97 / $499.23	Professional		$35.67	$185.97	$499.23
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $273.64 / $426.12 / $473.69	Facility		$273.64	$426.12	$473.69
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $185.62 / $317.10 / $323.10	Facility		$185.62	$317.10	$323.10
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $241.41 / $377.23 / $592.54	Professional		$241.41	$377.23	$592.54
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $4,294.21 / $6,618.43 / $12,667.56	Facility		$4,294.21	$6,618.43	$12,667.56
Regence BlueShield Facility/Professional Facility Modifier 50 Low / Median / High Price $6,441.32 / $9,927.65 / $19,001.34	Facility	50	$6,441.32	$9,927.65	$19,001.34
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $196.81 / $341.69 / $581.24	Professional		$196.81	$341.69	$581.24
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 $277.19 / $377.90 / $656.36	Professional		$277.19	$377.90	$656.36