Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $160.80 / $346.25 / $14,464.32	Facility		$160.80	$346.25	$14,464.32
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $120.60 / $183.31 / $259.68	Facility	54	$120.60	$183.31	$259.68
Aetna Facility/Professional Professional Modifier Low / Median / High Price $104.62 / $157.91 / $322.20	Professional		$104.62	$157.91	$322.20
Aetna Facility/Professional Professional Modifier 54 Low / Median / High Price $86.07 / $120.60 / $271.35	Professional	54	$86.07	$120.60	$271.35
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $138.56 / $138.56 / $138.56	Professional		$138.56	$138.56	$138.56
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $161.27 / $667.91 / $2,165.76	Facility		$161.27	$667.91	$2,165.76
Asuris Northwest Health Facility/Professional Facility Modifier 54 Low / Median / High Price $181.50 / $301.91 / $301.91	Facility	54	$181.50	$301.91	$301.91
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $171.38 / $277.73 / $1,079.25	Professional		$171.38	$277.73	$1,079.25
Asuris Northwest Health Facility/Professional Professional Modifier 54 Low / Median / High Price $181.04 / $225.74 / $225.74	Professional	54	$181.04	$225.74	$225.74
Cigna Facility/Professional Facility Modifier Low / Median / High Price $190.01 / $190.01 / $190.01	Facility		$190.01	$190.01	$190.01
Cigna Facility/Professional Professional Modifier Low / Median / High Price $127.75 / $238.96 / $386.27	Professional		$127.75	$238.96	$386.27
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $117.18 / $210.50 / $315.56	Facility		$117.18	$210.50	$315.56
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $117.18 / $207.09 / $315.20	Professional		$117.18	$207.09	$315.20
Molina Facility/Professional Professional Modifier Low / Median / High Price $21.61 / $77.94 / $231.76	Professional		$21.61	$77.94	$231.76
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $157.25 / $232.49 / $251.92	Facility		$157.25	$232.49	$251.92
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $56.96 / $161.27 / $171.83	Facility		$56.96	$161.27	$171.83
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $171.83 / $268.83 / $340.16	Professional		$171.83	$268.83	$340.16
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 $164.47 / $241.67 / $324.75	Professional		$164.47	$241.67	$324.75
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 $143.50 / $197.79 / $354.35	Professional		$143.50	$197.79	$354.35
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $104.91 / $104.91 / $141.47	Professional		$104.91	$104.91	$141.47