Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $74.83 / $631.09 / $5,539.00	Facility		$74.83	$631.09	$5,539.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $661.82 / $661.82 / $948.20	Facility	50	$661.82	$661.82	$948.20
Aetna Facility/Professional Professional Modifier Low / Median / High Price $58.09 / $120.17 / $348.12	Professional		$58.09	$120.17	$348.12
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $123.26 / $242.29 / $648.00	Professional	50	$123.26	$242.29	$648.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $91.02 / $147.69 / $207.86	Professional		$91.02	$147.69	$207.86
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $190.80 / $262.56 / $293.55	Professional	50	$190.80	$262.56	$293.55
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $128.83 / $786.75 / $1,605.58	Facility		$128.83	$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 $100.60 / $185.56 / $739.52	Professional		$100.60	$185.56	$739.52
Asuris Northwest Health Facility/Professional Professional Modifier 50 Low / Median / High Price $173.40 / $176.40 / $339.19	Professional	50	$173.40	$176.40	$339.19
Cigna Facility/Professional Facility Modifier Low / Median / High Price $131.79 / $765.00 / $870.49	Facility		$131.79	$765.00	$870.49
Cigna Facility/Professional Professional Modifier Low / Median / High Price $78.01 / $142.16 / $278.64	Professional		$78.01	$142.16	$278.64
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $71.64 / $128.41 / $230.35	Facility		$71.64	$128.41	$230.35
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 $71.64 / $128.41 / $219.85	Professional		$71.64	$128.41	$219.85
Molina Facility/Professional Professional Modifier Low / Median / High Price $27.14 / $151.09 / $269.28	Professional		$27.14	$151.09	$269.28
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $107.74 / $174.87 / $200.33	Facility		$107.74	$174.87	$200.33
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $42.91 / $133.63 / $136.63	Facility		$42.91	$133.63	$136.63
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $98.76 / $153.51 / $249.22	Professional		$98.76	$153.51	$249.22
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 $90.83 / $144.41 / $233.72	Professional		$90.83	$144.41	$233.72
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 $115.24 / $164.45 / $288.68	Professional		$115.24	$164.45	$288.68
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $61.65 / $82.27 / $109.40	Professional		$61.65	$82.27	$109.40