Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $95.22 / $228.10 / $11,522.02	Facility		$95.22	$228.10	$11,522.02
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $1,220.44 / $1,220.44 / $1,220.44	Facility	50	$1,220.44	$1,220.44	$1,220.44
Aetna Facility/Professional Professional Modifier Low / Median / High Price $50.35 / $93.66 / $228.10	Professional		$50.35	$93.66	$228.10
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $109.71 / $150.71 / $676.13	Professional	50	$109.71	$150.71	$676.13
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $82.10 / $99.28 / $164.21	Professional		$82.10	$99.28	$164.21
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $246.31 / $246.31 / $246.31	Professional	50	$246.31	$246.31	$246.31
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $115.27 / $1,836.95 / $3,748.81	Facility		$115.27	$1,836.95	$3,748.81
Asuris Northwest Health Facility/Professional Facility Modifier 50 Low / Median / High Price $2,191.65 / $2,939.66 / $5,687.07	Facility	50	$2,191.65	$2,939.66	$5,687.07
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $89.07 / $166.53 / $671.04	Professional		$89.07	$166.53	$671.04
Asuris Northwest Health Facility/Professional Professional Modifier 50 Low / Median / High Price $126.49 / $156.30 / $294.30	Professional	50	$126.49	$156.30	$294.30
Cigna Facility/Professional Facility Modifier Low / Median / High Price $120.28 / $765.00 / $870.49	Facility		$120.28	$765.00	$870.49
Cigna Facility/Professional Professional Modifier Low / Median / High Price $67.84 / $124.05 / $250.26	Professional		$67.84	$124.05	$250.26
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $61.60 / $110.20 / $201.66	Facility		$61.60	$110.20	$201.66
Kaiser Permanente Facility/Professional Facility Modifier 50 Low / Median / High Price $770.92 / $1,928.84 / $4,640.79	Facility	50	$770.92	$1,928.84	$4,640.79
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $61.60 / $110.20 / $194.01	Professional		$61.60	$110.20	$194.01
Molina Facility/Professional Professional Modifier Low / Median / High Price $27.13 / $151.09 / $269.28	Professional		$27.13	$151.09	$269.28
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $95.76 / $152.76 / $181.57	Facility		$95.76	$152.76	$181.57
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $38.39 / $119.59 / $123.85	Facility		$38.39	$119.59	$123.85
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $92.52 / $137.18 / $222.54	Professional		$92.52	$137.18	$222.54
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $1,270.82 / $1,958.65 / $3,748.81	Facility		$1,270.82	$1,958.65	$3,748.81
Regence BlueShield Facility/Professional Facility Modifier 50 Low / Median / High Price $1,906.23 / $2,937.98 / $5,623.22	Facility	50	$1,906.23	$2,937.98	$5,623.22
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $79.80 / $127.62 / $209.30	Professional		$79.80	$127.62	$209.30
United Facility/Professional Facility Modifier Low / Median / High Price $472.00 / $938.00 / $4,611.00	Facility		$472.00	$938.00	$4,611.00
United Facility/Professional Professional Modifier Low / Median / High Price $99.20 / $133.16 / $253.65	Professional		$99.20	$133.16	$253.65
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $54.29 / $74.54 / $99.28	Professional		$54.29	$74.54	$99.28