Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $125.23 / $275.36 / $5,116.62	Facility		$125.23	$275.36	$5,116.62
Aetna Facility/Professional Professional Modifier Low / Median / High Price $58.17 / $112.09 / $297.00	Professional		$58.17	$112.09	$297.00
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $30.14 / $48.94 / $128.81	Professional	52	$30.14	$48.94	$128.81
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $91.96 / $147.12 / $239.48	Professional		$91.96	$147.12	$239.48
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $208.22 / $567.02 / $1,107.58	Facility		$208.22	$567.02	$1,107.58
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $95.96 / $217.54 / $848.56	Professional		$95.96	$217.54	$848.56
Asuris Northwest Health Facility/Professional Professional Modifier 50 Low / Median / High Price $126.17 / $336.77 / $336.77	Professional	50	$126.17	$336.77	$336.77
Cigna Facility/Professional Professional Modifier Low / Median / High Price $89.33 / $152.99 / $306.47	Professional		$89.33	$152.99	$306.47
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $98.00 / $160.21 / $281.76	Facility		$98.00	$160.21	$281.76
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $99.20 / $162.24 / $287.60	Professional		$99.20	$162.24	$287.60
Molina Facility/Professional Professional Modifier Low / Median / High Price $31.89 / $174.43 / $324.46	Professional		$31.89	$174.43	$324.46
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $111.15 / $204.36 / $229.81	Facility		$111.15	$204.36	$229.81
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $152.66 / $152.66 / $156.75	Facility		$152.66	$152.66	$156.75
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $97.29 / $164.71 / $284.22	Professional		$97.29	$164.71	$284.22
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 $90.09 / $155.69 / $265.48	Professional		$90.09	$155.69	$265.48
United Facility/Professional Facility Modifier Low / Median / High Price $140.00 / $414.00 / $5,793.00	Facility		$140.00	$414.00	$5,793.00
United Facility/Professional Professional Modifier Low / Median / High Price $129.97 / $157.88 / $323.95	Professional		$129.97	$157.88	$323.95
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $77.76 / $77.76 / $129.44	Professional		$77.76	$77.76	$129.44