Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,924.21 / $35,293.97 / $97,447.49	Facility		$1,924.21	$35,293.97	$97,447.49
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $298.47 / $325.14 / $611.00	Facility	53	$298.47	$325.14	$611.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $966.62 / $1,336.72 / $3,085.99	Professional		$966.62	$1,336.72	$3,085.99
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $1,460.51 / $1,460.51 / $1,460.51	Professional		$1,460.51	$1,460.51	$1,460.51
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $26,727.00 / $67,267.53 / $128,748.78	Facility		$26,727.00	$67,267.53	$128,748.78
Asuris Northwest Health Facility/Professional Facility Modifier 53 Low / Median / High Price $255.67 / $5,345.40 / $5,345.40	Facility	53	$255.67	$5,345.40	$5,345.40
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $1,517.16 / $2,217.27 / $8,105.33	Professional		$1,517.16	$2,217.27	$8,105.33
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,469.04 / $1,912.11 / $2,844.28	Professional		$1,469.04	$1,912.11	$2,844.28
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,372.08 / $2,540.01 / $63,834.23	Facility		$1,372.08	$2,540.01	$63,834.23
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,372.08 / $2,272.79 / $2,823.43	Professional		$1,372.08	$2,272.79	$2,823.43
Molina Facility/Professional Professional Modifier Low / Median / High Price $233.26 / $1,448.40 / $2,341.46	Professional		$233.26	$1,448.40	$2,341.46
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,519.99 / $1,855.23 / $2,231.76	Facility		$1,519.99	$1,855.23	$2,231.76
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,265.43 / $1,265.43 / $1,488.56	Facility		$1,265.43	$1,265.43	$1,488.56
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,352.60 / $2,131.28 / $2,550.87	Professional		$1,352.60	$2,131.28	$2,550.87
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $44,539.31 / $67,267.53 / $128,748.78	Facility		$44,539.31	$67,267.53	$128,748.78
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $1,508.34 / $1,820.34 / $2,451.94	Professional		$1,508.34	$1,820.34	$2,451.94
United Facility/Professional Facility Modifier Low / Median / High Price $3,960.00 / $16,613.00 / $61,876.00	Facility		$3,960.00	$16,613.00	$61,876.00
United Facility/Professional Professional Modifier Low / Median / High Price $1,370.04 / $1,872.24 / $2,843.80	Professional		$1,370.04	$1,872.24	$2,843.80