Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $72.31 / $528.42 / $4,497.00	Facility		$72.31	$528.42	$4,497.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $335.90 / $335.90 / $999.96	Facility	50	$335.90	$335.90	$999.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $38.34 / $73.27 / $281.20	Professional		$38.34	$73.27	$281.20
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $73.20 / $176.46 / $388.50	Professional	50	$73.20	$176.46	$388.50
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $51.57 / $77.36 / $117.62	Professional		$51.57	$77.36	$117.62
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $112.91 / $135.16 / $176.43	Professional	50	$112.91	$135.16	$176.43
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $64.05 / $820.72 / $1,856.26	Facility		$64.05	$820.72	$1,856.26
Asuris Northwest Health Facility/Professional Facility Modifier 50 Low / Median / High Price $905.78 / $1,259.03 / $2,435.71	Facility	50	$905.78	$1,259.03	$2,435.71
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $65.94 / $111.01 / $499.80	Professional		$65.94	$111.01	$499.80
Asuris Northwest Health Facility/Professional Professional Modifier 50 Low / Median / High Price $88.24 / $173.87 / $252.00	Professional	50	$88.24	$173.87	$252.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $68.95 / $500.00 / $568.48	Facility		$68.95	$500.00	$568.48
Cigna Facility/Professional Professional Modifier Low / Median / High Price $48.59 / $86.59 / $161.94	Professional		$48.59	$86.59	$161.94
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $45.60 / $81.42 / $143.03	Facility		$45.60	$81.42	$143.03
Kaiser Permanente Facility/Professional Facility Modifier 50 Low / Median / High Price $670.80 / $878.49 / $2,113.65	Facility	50	$670.80	$878.49	$2,113.65
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $45.37 / $80.56 / $134.05	Professional		$45.37	$80.56	$134.05
Molina Facility/Professional Professional Modifier Low / Median / High Price $18.02 / $101.08 / $178.26	Professional		$18.02	$101.08	$178.26
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $68.34 / $104.52 / $116.58	Facility		$68.34	$104.52	$116.58
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $21.33 / $77.01 / $79.52	Facility		$21.33	$77.01	$79.52
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $65.27 / $96.49 / $143.11	Professional		$65.27	$96.49	$143.11
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $544.28 / $838.87 / $1,605.58	Facility		$544.28	$838.87	$1,605.58
Regence BlueShield Facility/Professional Facility Modifier 50 Low / Median / High Price $816.42 / $1,258.31 / $2,408.37	Facility	50	$816.42	$1,258.31	$2,408.37
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $59.33 / $91.22 / $135.60	Professional		$59.33	$91.22	$135.60
United Facility/Professional Facility Modifier Low / Median / High Price $157.00 / $546.00 / $5,793.00	Facility		$157.00	$546.00	$5,793.00
United Facility/Professional Professional Modifier Low / Median / High Price $68.64 / $95.14 / $175.49	Professional		$68.64	$95.14	$175.49
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $40.69 / $48.31 / $63.58	Professional		$40.69	$48.31	$63.58