Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $144.05 / $553.37 / $4,497.00	Facility		$144.05	$553.37	$4,497.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $101.60 / $177.79 / $233.10	Facility	54	$101.60	$177.79	$233.10
Aetna Facility/Professional Professional Modifier Low / Median / High Price $84.37 / $135.47 / $299.63	Professional		$84.37	$135.47	$299.63
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $104.38 / $115.46 / $264.57	Professional		$104.38	$115.46	$264.57
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $94.97 / $554.76 / $1,107.58	Facility		$94.97	$554.76	$1,107.58
Asuris Northwest Health Facility/Professional Facility Modifier 54 Low / Median / High Price $196.14 / $303.10 / $343.32	Facility	54	$196.14	$303.10	$343.32
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $147.15 / $269.74 / $950.56	Professional		$147.15	$269.74	$950.56
Cigna Facility/Professional Facility Modifier Low / Median / High Price $125.47 / $125.47 / $190.77	Facility		$125.47	$125.47	$190.77
Cigna Facility/Professional Professional Modifier Low / Median / High Price $124.39 / $195.80 / $364.26	Professional		$124.39	$195.80	$364.26
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $120.60 / $183.40 / $302.77	Facility		$120.60	$183.40	$302.77
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $120.91 / $194.60 / $318.77	Professional		$120.91	$194.60	$318.77
Molina Facility/Professional Professional Modifier Low / Median / High Price $27.11 / $150.05 / $267.18	Professional		$27.11	$150.05	$267.18
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $113.15 / $162.68 / $251.83	Facility		$113.15	$162.68	$251.83
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $67.95 / $167.16 / $175.03	Facility		$67.95	$167.16	$175.03
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $151.34 / $245.75 / $320.58	Professional		$151.34	$245.75	$320.58
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $367.90 / $567.35 / $1,085.27	Facility		$367.90	$567.35	$1,085.27
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $142.30 / $202.48 / $299.30	Professional		$142.30	$202.48	$299.30
United Facility/Professional Facility Modifier Low / Median / High Price $140.00 / $648.00 / $5,793.00	Facility		$140.00	$648.00	$5,793.00
United Facility/Professional Professional Modifier Low / Median / High Price $139.15 / $188.50 / $378.27	Professional		$139.15	$188.50	$378.27
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $119.33 / $119.33 / $143.01	Professional		$119.33	$119.33	$143.01