Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $402.36 / $731.20 / $12,214.00	Facility		$402.36	$731.20	$12,214.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $301.77 / $437.43 / $589.69	Facility	54	$301.77	$437.43	$589.69
Aetna Facility/Professional Professional Modifier Low / Median / High Price $245.16 / $380.32 / $786.26	Professional		$245.16	$380.32	$786.26
Aetna Facility/Professional Professional Modifier 54 Low / Median / High Price $201.09 / $301.77 / $627.29	Professional	54	$201.09	$301.77	$627.29
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $391.30 / $391.30 / $632.00	Professional		$391.30	$391.30	$632.00
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $232.18 / $668.30 / $1,477.97	Facility		$232.18	$668.30	$1,477.97
Asuris Northwest Health Facility/Professional Facility Modifier 54 Low / Median / High Price $546.29 / $969.60 / $969.60	Facility	54	$546.29	$969.60	$969.60
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $418.57 / $693.96 / $2,621.33	Professional		$418.57	$693.96	$2,621.33
Asuris Northwest Health Facility/Professional Professional Modifier 54 Low / Median / High Price $431.66 / $538.26 / $564.09	Professional	54	$431.66	$538.26	$564.09
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 $294.83 / $565.59 / $967.49	Professional		$294.83	$565.59	$967.49
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $235.16 / $467.04 / $748.23	Facility		$235.16	$467.04	$748.23
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $245.52 / $470.10 / $749.21	Professional		$245.52	$470.10	$749.21
Molina Facility/Professional Professional Modifier Low / Median / High Price $38.18 / $181.05 / $612.17	Professional		$38.18	$181.05	$612.17
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $368.63 / $559.45 / $634.49	Facility		$368.63	$559.45	$634.49
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $77.31 / $410.42 / $432.78	Facility		$77.31	$410.42	$432.78
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $432.78 / $663.24 / $818.20	Professional		$432.78	$663.24	$818.20
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 $416.69 / $592.97 / $784.88	Professional		$416.69	$592.97	$784.88
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 $322.92 / $448.97 / $853.82	Professional		$322.92	$448.97	$853.82
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $264.75 / $340.26 / $357.63	Professional		$264.75	$340.26	$357.63