Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $35.89 / $180.50 / $736.15	Facility		$35.89	$180.50	$736.15
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $372.46 / $853.24 / $983.62	Facility	50	$372.46	$853.24	$983.62
Aetna Facility/Professional Professional Modifier Low / Median / High Price $28.98 / $83.84 / $169.92	Professional		$28.98	$83.84	$169.92
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $33.42 / $137.72 / $237.85	Professional	50	$33.42	$137.72	$237.85
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $87.08 / $94.47 / $94.47	Professional		$87.08	$94.47	$94.47
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $120.50 / $418.55 / $854.16	Facility		$120.50	$418.55	$854.16
Asuris Northwest Health Facility/Professional Facility Modifier 50 Low / Median / High Price $492.71 / $669.80 / $1,295.79	Facility	50	$492.71	$669.80	$1,295.79
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $45.87 / $158.78 / $659.52	Professional		$45.87	$158.78	$659.52
Asuris Northwest Health Facility/Professional Professional Modifier 50 Low / Median / High Price $66.38 / $82.77 / $253.50	Professional	50	$66.38	$82.77	$253.50
Cigna Facility/Professional Facility Modifier Low / Median / High Price $153.22 / $714.97 / $870.49	Facility		$153.22	$714.97	$870.49
Cigna Facility/Professional Professional Modifier Low / Median / High Price $35.63 / $87.44 / $240.24	Professional		$35.63	$87.44	$240.24
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $21.24 / $83.70 / $212.76	Facility		$21.24	$83.70	$212.76
Kaiser Permanente Facility/Professional Facility Modifier 50 Low / Median / High Price $281.60 / $475.95 / $1,145.11	Facility	50	$281.60	$475.95	$1,145.11
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $24.33 / $78.31 / $206.93	Professional		$24.33	$78.31	$206.93
Molina Facility/Professional Professional Modifier Low / Median / High Price $26.65 / $151.09 / $269.28	Professional		$26.65	$151.09	$269.28
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $64.67 / $143.54 / $176.88	Facility		$64.67	$143.54	$176.88
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $51.18 / $120.50 / $153.69	Facility		$51.18	$120.50	$153.69
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $43.88 / $87.84 / $221.88	Professional		$43.88	$87.84	$221.88
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $289.56 / $446.53 / $854.16	Facility		$289.56	$446.53	$854.16
Regence BlueShield Facility/Professional Facility Modifier 50 Low / Median / High Price $434.34 / $669.80 / $1,281.24	Facility	50	$434.34	$669.80	$1,281.24
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $42.00 / $87.90 / $212.05	Professional		$42.00	$87.90	$212.05
United Facility/Professional Facility Modifier Low / Median / High Price $427.08 / $585.29 / $1,086.00	Facility		$427.08	$585.29	$1,086.00
United Facility/Professional Professional Modifier Low / Median / High Price $99.30 / $139.69 / $257.79	Professional		$99.30	$139.69	$257.79
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $27.62 / $72.05 / $99.44	Professional		$27.62	$72.05	$99.44