Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $453.25 / $855.00 / $10,122.46	Facility		$453.25	$855.00	$10,122.46
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $339.94 / $552.61 / $700.34	Facility	54	$339.94	$552.61	$700.34
Aetna Facility/Professional Professional Modifier Low / Median / High Price $247.37 / $430.73 / $876.81	Professional		$247.37	$430.73	$876.81
Aetna Facility/Professional Professional Modifier 54 Low / Median / High Price $219.52 / $339.94 / $700.34	Professional	54	$219.52	$339.94	$700.34
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $305.82 / $461.76 / $1,110.00	Professional		$305.82	$461.76	$1,110.00
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $232.18 / $668.30 / $1,588.76	Facility		$232.18	$668.30	$1,588.76
Asuris Northwest Health Facility/Professional Facility Modifier 54 Low / Median / High Price $617.27 / $1,094.65 / $1,094.65	Facility	54	$617.27	$1,094.65	$1,094.65
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $471.32 / $779.38 / $2,959.35	Professional		$471.32	$779.38	$2,959.35
Asuris Northwest Health Facility/Professional Professional Modifier 50 Low / Median / High Price $811.92 / $1,012.44 / $1,474.50	Professional	50	$811.92	$1,012.44	$1,474.50
Asuris Northwest Health Facility/Professional Professional Modifier 54 Low / Median / High Price $507.87 / $607.46 / $613.64	Professional	54	$507.87	$607.46	$613.64
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 $326.14 / $614.22 / $1,091.40	Professional		$326.14	$614.22	$1,091.40
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $235.16 / $514.48 / $836.67	Facility		$235.16	$514.48	$836.67
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $262.64 / $514.48 / $845.64	Professional		$262.64	$514.48	$845.64
Molina Facility/Professional Professional Modifier Low / Median / High Price $39.46 / $238.37 / $690.97	Professional		$39.46	$238.37	$690.97
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $400.82 / $619.75 / $712.88	Facility		$400.82	$619.75	$712.88
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $77.31 / $461.61 / $486.25	Facility		$77.31	$461.61	$486.25
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $486.25 / $748.79 / $923.43	Professional		$486.25	$748.79	$923.43
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 $470.78 / $668.17 / $881.78	Professional		$470.78	$668.17	$881.78
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 $376.28 / $555.86 / $1,008.94	Professional		$376.28	$555.86	$1,008.94
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $297.32 / $385.32 / $402.69	Professional		$297.32	$385.32	$402.69