Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $114.30 / $226.02 / $688.46	Facility		$114.30	$226.02	$688.46
Aetna Facility/Professional Professional Modifier Low / Median / High Price $59.69 / $103.58 / $274.50	Professional		$59.69	$103.58	$274.50
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $650.03 / $650.03 / $650.03	Professional	50	$650.03	$650.03	$650.03
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $122.65 / $163.54 / $272.95	Professional		$122.65	$163.54	$272.95
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $115.06 / $744.18 / $1,455.83	Facility		$115.06	$744.18	$1,455.83
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $104.03 / $173.79 / $659.04	Professional		$104.03	$173.79	$659.04
Asuris Northwest Health Facility/Professional Professional Modifier 50 Low / Median / High Price $151.40 / $269.04 / $326.33	Professional	50	$151.40	$269.04	$326.33
Cigna Facility/Professional Facility Modifier Low / Median / High Price $139.44 / $139.44 / $139.44	Facility		$139.44	$139.44	$139.44
Cigna Facility/Professional Professional Modifier Low / Median / High Price $75.48 / $136.38 / $257.10	Professional		$75.48	$136.38	$257.10
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $75.95 / $127.54 / $221.47	Facility		$75.95	$127.54	$221.47
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $75.95 / $127.20 / $211.74	Professional		$75.95	$127.20	$211.74
Molina Facility/Professional Professional Modifier Low / Median / High Price $27.16 / $151.02 / $269.28	Professional		$27.16	$151.02	$269.28
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $104.24 / $163.10 / $180.23	Facility		$104.24	$163.10	$180.23
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $40.90 / $115.06 / $122.93	Facility		$40.90	$115.06	$122.93
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $104.10 / $156.22 / $220.88	Professional		$104.10	$156.22	$220.88
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $550.49 / $761.06 / $1,455.83	Facility		$550.49	$761.06	$1,455.83
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $92.40 / $142.40 / $208.72	Professional		$92.40	$142.40	$208.72
United Facility/Professional Facility Modifier Low / Median / High Price $546.00 / $949.88 / $1,827.82	Facility		$546.00	$949.88	$1,827.82
United Facility/Professional Professional Modifier Low / Median / High Price $104.49 / $140.94 / $251.75	Professional		$104.49	$140.94	$251.75
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $69.86 / $75.92 / $102.21	Professional		$69.86	$75.92	$102.21