Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $467.95 / $743.92 / $13,750.00	Facility		$467.95	$743.92	$13,750.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $265.92 / $383.60 / $520.02	Facility	54	$265.92	$383.60	$520.02
Aetna Facility/Professional Professional Modifier Low / Median / High Price $215.47 / $331.01 / $693.36	Professional		$215.47	$331.01	$693.36
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $266.17 / $361.11 / $555.55	Professional		$266.17	$361.11	$555.55
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $232.18 / $667.91 / $1,278.36	Facility		$232.18	$667.91	$1,278.36
Asuris Northwest Health Facility/Professional Facility Modifier 54 Low / Median / High Price $468.05 / $833.97 / $833.97	Facility	54	$468.05	$833.97	$833.97
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $366.37 / $600.03 / $2,249.92	Professional		$366.37	$600.03	$2,249.92
Cigna Facility/Professional Facility Modifier Low / Median / High Price $305.39 / $305.39 / $305.39	Facility		$305.39	$305.39	$305.39
Cigna Facility/Professional Professional Modifier Low / Median / High Price $262.20 / $491.05 / $841.04	Professional		$262.20	$491.05	$841.04
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $224.44 / $412.50 / $661.90	Facility		$224.44	$412.50	$661.90
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $229.32 / $415.68 / $661.90	Professional		$229.32	$415.68	$661.90
Molina Facility/Professional Professional Modifier Low / Median / High Price $37.39 / $220.25 / $584.32	Professional		$37.39	$220.25	$584.32
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $355.74 / $494.46 / $556.77	Facility		$355.74	$494.46	$556.77
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $77.31 / $359.23 / $379.77	Facility		$77.31	$359.23	$379.77
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $379.77 / $576.76 / $702.10	Professional		$379.77	$576.76	$702.10
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $433.36 / $667.91 / $1,278.36	Facility		$433.36	$667.91	$1,278.36
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $356.27 / $510.65 / $685.95	Professional		$356.27	$510.65	$685.95
United Facility/Professional Facility Modifier Low / Median / High Price $546.00 / $857.96 / $1,650.96	Facility		$546.00	$857.96	$1,650.96
United Facility/Professional Professional Modifier Low / Median / High Price $315.42 / $428.06 / $786.88	Professional		$315.42	$428.06	$786.88
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $233.00 / $291.64 / $314.14	Professional		$233.00	$291.64	$314.14