Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $69.88 / $661.82 / $5,116.62	Facility		$69.88	$661.82	$5,116.62
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $778.31 / $1,167.46 / $7,257.50	Facility	50	$778.31	$1,167.46	$7,257.50
Aetna Facility/Professional Professional Modifier Low / Median / High Price $37.58 / $69.88 / $256.00	Professional		$37.58	$69.88	$256.00
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $96.88 / $171.85 / $409.50	Professional	50	$96.88	$171.85	$409.50
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $47.26 / $63.64 / $101.84	Professional		$47.26	$63.64	$101.84
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $88.62 / $88.62 / $104.01	Professional	50	$88.62	$88.62	$104.01
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $75.86 / $839.35 / $2,165.76	Facility		$75.86	$839.35	$2,165.76
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 $63.10 / $106.00 / $411.20	Professional		$63.10	$106.00	$411.20
Asuris Northwest Health Facility/Professional Professional Modifier 50 Low / Median / High Price $105.00 / $159.26 / $190.50	Professional	50	$105.00	$159.26	$190.50
Cigna Facility/Professional Facility Modifier Low / Median / High Price $68.19 / $500.00 / $568.48	Facility		$68.19	$500.00	$568.48
Cigna Facility/Professional Professional Modifier Low / Median / High Price $46.35 / $83.96 / $154.72	Professional		$46.35	$83.96	$154.72
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $45.94 / $82.62 / $153.54	Facility		$45.94	$82.62	$153.54
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 $45.83 / $79.92 / $133.18	Professional		$45.83	$79.92	$133.18
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 $59.90 / $96.38 / $111.22	Facility		$59.90	$96.38	$111.22
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $21.33 / $73.39 / $75.86	Facility		$21.33	$73.39	$75.86
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $61.87 / $91.69 / $137.53	Professional		$61.87	$91.69	$137.53
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 $56.70 / $87.22 / $129.94	Professional		$56.70	$87.22	$129.94
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 $63.90 / $88.50 / $156.74	Professional		$63.90	$88.50	$156.74
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $38.57 / $45.55 / $60.27	Professional		$38.57	$45.55	$60.27