Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $67.12 / $689.88 / $5,539.00	Facility		$67.12	$689.88	$5,539.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $285.86 / $709.64 / $8,055.91	Facility	50	$285.86	$709.64	$8,055.91
Aetna Facility/Professional Professional Modifier Low / Median / High Price $35.71 / $67.13 / $198.00	Professional		$35.71	$67.13	$198.00
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $71.09 / $172.47 / $334.50	Professional	50	$71.09	$172.47	$334.50
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $46.42 / $71.79 / $106.36	Professional		$46.42	$71.79	$106.36
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $122.73 / $149.97 / $149.97	Professional	50	$122.73	$149.97	$149.97
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $61.78 / $820.72 / $1,605.58	Facility		$61.78	$820.72	$1,605.58
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 $60.78 / $103.06 / $400.96	Professional		$60.78	$103.06	$400.96
Asuris Northwest Health Facility/Professional Professional Modifier 50 Low / Median / High Price $102.00 / $161.22 / $186.00	Professional	50	$102.00	$161.22	$186.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $67.41 / $500.00 / $568.48	Facility		$67.41	$500.00	$568.48
Cigna Facility/Professional Professional Modifier Low / Median / High Price $44.61 / $80.53 / $150.96	Professional		$44.61	$80.53	$150.96
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $41.85 / $72.51 / $121.50	Facility		$41.85	$72.51	$121.50
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 $41.82 / $71.70 / $118.59	Professional		$41.82	$71.70	$118.59
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 $64.77 / $91.66 / $108.54	Facility		$64.77	$91.66	$108.54
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $20.58 / $71.12 / $74.03	Facility		$20.58	$71.12	$74.03
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $59.60 / $87.52 / $131.69	Professional		$59.60	$87.52	$131.69
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 $54.60 / $84.02 / $125.58	Professional		$54.60	$84.02	$125.58
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 $60.76 / $80.61 / $144.65	Professional		$60.76	$80.61	$144.65
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $37.50 / $44.72 / $59.20	Professional		$37.50	$44.72	$59.20