Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $206.83 / $495.11 / $14,464.32	Facility		$206.83	$495.11	$14,464.32
Aetna Facility/Professional Professional Modifier Low / Median / High Price $97.87 / $172.53 / $354.59	Professional		$97.87	$172.53	$354.59
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $260.91 / $260.91 / $260.91	Professional	50	$260.91	$260.91	$260.91
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $112.64 / $691.81 / $1,324.12	Facility		$112.64	$691.81	$1,324.12
Asuris Northwest Health Facility/Professional Facility Modifier 50 Low / Median / High Price $764.72 / $1,038.32 / $2,008.73	Facility	50	$764.72	$1,038.32	$2,008.73
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $203.11 / $372.49 / $1,382.56	Professional		$203.11	$372.49	$1,382.56
Asuris Northwest Health Facility/Professional Professional Modifier 50 Low / Median / High Price $160.63 / $322.64 / $530.30	Professional	50	$160.63	$322.64	$530.30
Cigna Facility/Professional Facility Modifier Low / Median / High Price $176.48 / $176.48 / $294.02	Facility		$176.48	$176.48	$294.02
Cigna Facility/Professional Professional Modifier Low / Median / High Price $176.81 / $319.95 / $570.10	Professional		$176.81	$319.95	$570.10
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $158.61 / $256.44 / $492.70	Facility		$158.61	$256.44	$492.70
Kaiser Permanente Facility/Professional Facility Modifier 50 Low / Median / High Price $673.47 / $892.36 / $1,620.37	Facility	50	$673.47	$892.36	$1,620.37
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $158.61 / $263.25 / $455.21	Professional		$158.61	$263.25	$455.21
Molina Facility/Professional Professional Modifier Low / Median / High Price $39.01 / $246.66 / $422.23	Professional		$39.01	$246.66	$422.23
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $184.25 / $343.22 / $375.87	Facility		$184.25	$343.22	$375.87
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $112.64 / $250.06 / $256.38	Facility		$112.64	$250.06	$256.38
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $199.96 / $289.20 / $469.95	Professional		$199.96	$289.20	$469.95
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $505.09 / $676.85 / $1,324.12	Facility		$505.09	$676.85	$1,324.12
Regence BlueShield Facility/Professional Facility Modifier 50 Low / Median / High Price $757.64 / $1,015.28 / $1,986.18	Facility	50	$757.64	$1,015.28	$1,986.18
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $189.79 / $277.72 / $434.21	Professional		$189.79	$277.72	$434.21
United Facility/Professional Facility Modifier Low / Median / High Price $190.00 / $666.00 / $6,216.00	Facility		$190.00	$666.00	$6,216.00
United Facility/Professional Professional Modifier Low / Median / High Price $227.24 / $395.57 / $541.65	Professional		$227.24	$395.57	$541.65