Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $84.18 / $206.37 / $14,464.32	Facility		$84.18	$206.37	$14,464.32
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $344.94 / $344.94 / $344.94	Facility	50	$344.94	$344.94	$344.94
Aetna Facility/Professional Professional Modifier Low / Median / High Price $43.67 / $84.47 / $201.84	Professional		$43.67	$84.47	$201.84
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $99.29 / $102.42 / $294.45	Professional	50	$99.29	$102.42	$294.45
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $85.23 / $111.01 / $170.46	Professional		$85.23	$111.01	$170.46
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $108.48 / $786.75 / $1,605.58	Facility		$108.48	$786.75	$1,605.58
Asuris Northwest Health Facility/Professional Facility Modifier 50 Low / Median / High Price $922.10 / $1,259.03 / $2,435.71	Facility	50	$922.10	$1,259.03	$2,435.71
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $77.41 / $151.30 / $618.24	Professional		$77.41	$151.30	$618.24
Asuris Northwest Health Facility/Professional Professional Modifier 50 Low / Median / High Price $111.87 / $139.07 / $265.39	Professional	50	$111.87	$139.07	$265.39
Cigna Facility/Professional Facility Modifier Low / Median / High Price $114.17 / $765.00 / $870.49	Facility		$114.17	$765.00	$870.49
Cigna Facility/Professional Professional Modifier Low / Median / High Price $58.98 / $110.98 / $227.40	Professional		$58.98	$110.98	$227.40
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $55.44 / $100.12 / $183.10	Facility		$55.44	$100.12	$183.10
Kaiser Permanente Facility/Professional Facility Modifier 50 Low / Median / High Price $770.92 / $878.49 / $2,113.65	Facility	50	$770.92	$878.49	$2,113.65
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $55.44 / $100.12 / $174.93	Professional		$55.44	$100.12	$174.93
Molina Facility/Professional Professional Modifier Low / Median / High Price $18.18 / $101.30 / $178.72	Professional		$18.18	$101.30	$178.72
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $86.52 / $138.51 / $166.83	Facility		$86.52	$138.51	$166.83
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $36.13 / $110.08 / $113.79	Facility		$36.13	$110.08	$113.79
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $76.63 / $118.95 / $205.04	Professional		$76.63	$118.95	$205.04
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $612.46 / $838.87 / $1,605.58	Facility		$612.46	$838.87	$1,605.58
Regence BlueShield Facility/Professional Facility Modifier 50 Low / Median / High Price $918.69 / $1,258.31 / $2,408.37	Facility	50	$918.69	$1,258.31	$2,408.37
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $69.30 / $112.27 / $189.65	Professional		$69.30	$112.27	$189.65
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 $92.25 / $134.53 / $237.51	Professional		$92.25	$134.53	$237.51
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $48.33 / $69.02 / $92.14	Professional		$48.33	$69.02	$92.14