Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $271.33 / $585.52 / $10,122.46	Facility		$271.33	$585.52	$10,122.46
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $218.60 / $322.64 / $439.14	Facility	54	$218.60	$322.64	$439.14
Aetna Facility/Professional Professional Modifier Low / Median / High Price $178.40 / $271.37 / $584.38	Professional		$178.40	$271.37	$584.38
Aetna Facility/Professional Professional Modifier 54 Low / Median / High Price $147.30 / $218.60 / $441.04	Professional	54	$147.30	$218.60	$441.04
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $207.75 / $339.18 / $449.56	Professional		$207.75	$339.18	$449.56
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 $387.30 / $681.37 / $681.37	Facility	54	$387.30	$681.37	$681.37
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $300.76 / $490.74 / $1,841.48	Professional		$300.76	$490.74	$1,841.48
Asuris Northwest Health Facility/Professional Professional Modifier 54 Low / Median / High Price $323.86 / $391.30 / $403.83	Professional	54	$323.86	$391.30	$403.83
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 $220.09 / $405.70 / $686.50	Professional		$220.09	$405.70	$686.50
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $198.40 / $352.80 / $550.83	Facility		$198.40	$352.80	$550.83
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $198.40 / $352.80 / $550.83	Professional		$198.40	$352.80	$550.83
Molina Facility/Professional Professional Modifier Low / Median / High Price $36.99 / $204.62 / $508.99	Professional		$36.99	$204.62	$508.99
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $294.49 / $418.75 / $453.59	Facility		$294.49	$418.75	$453.59
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $77.31 / $294.89 / $309.39	Facility		$77.31	$294.89	$309.39
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $309.39 / $473.29 / $578.73	Professional		$309.39	$473.29	$578.73
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 $295.83 / $419.43 / $564.95	Professional		$295.83	$419.43	$564.95
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 $257.50 / $344.30 / $640.12	Professional		$257.50	$344.30	$640.12
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $188.00 / $238.80 / $253.79	Professional		$188.00	$238.80	$253.79