Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $135.96 / $496.65 / $13,750.00	Facility		$135.96	$496.65	$13,750.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $1,107.53 / $1,107.53 / $1,107.53	Facility	50	$1,107.53	$1,107.53	$1,107.53
Aetna Facility/Professional Professional Modifier Low / Median / High Price $93.75 / $177.30 / $376.10	Professional		$93.75	$177.30	$376.10
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $267.48 / $267.48 / $1,279.50	Professional	50	$267.48	$267.48	$1,279.50
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $121.02 / $313.06 / $410.66	Professional		$121.02	$313.06	$410.66
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $374.13 / $1,173.53 / $9,102.00	Facility		$374.13	$1,173.53	$9,102.00
Asuris Northwest Health Facility/Professional Facility Modifier 50 Low / Median / High Price $1,149.54 / $1,695.00 / $3,279.15	Facility	50	$1,149.54	$1,695.00	$3,279.15
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $135.19 / $368.09 / $1,466.96	Professional		$135.19	$368.09	$1,466.96
Asuris Northwest Health Facility/Professional Professional Modifier 50 Low / Median / High Price $140.49 / $212.33 / $691.50	Professional	50	$140.49	$212.33	$691.50
Cigna Facility/Professional Facility Modifier Low / Median / High Price $317.18 / $317.18 / $317.18	Facility		$317.18	$317.18	$317.18
Cigna Facility/Professional Professional Modifier Low / Median / High Price $118.22 / $231.80 / $605.22	Professional		$118.22	$231.80	$605.22
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $125.92 / $228.86 / $483.47	Facility		$125.92	$228.86	$483.47
Kaiser Permanente Facility/Professional Facility Modifier 50 Low / Median / High Price $228.86 / $1,474.51 / $2,677.47	Facility	50	$228.86	$1,474.51	$2,677.47
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $119.35 / $226.64 / $475.47	Professional		$119.35	$226.64	$475.47
Molina Facility/Professional Professional Modifier Low / Median / High Price $51.83 / $318.61 / $524.41	Professional		$51.83	$318.61	$524.41
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $194.30 / $332.99 / $401.33	Facility		$194.30	$332.99	$401.33
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $270.89 / $270.89 / $273.74	Facility		$270.89	$270.89	$273.74
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $133.11 / $247.95 / $496.94	Professional		$133.11	$247.95	$496.94
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $732.75 / $1,129.34 / $2,161.55	Facility		$732.75	$1,129.34	$2,161.55
Regence BlueShield Facility/Professional Facility Modifier 50 Low / Median / High Price $1,099.13 / $1,694.03 / $3,242.33	Facility	50	$1,099.13	$1,694.03	$3,242.33
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $114.06 / $228.91 / $463.63	Professional		$114.06	$228.91	$463.63
United Facility/Professional Facility Modifier Low / Median / High Price $497.00 / $1,078.00 / $6,216.00	Facility		$497.00	$1,078.00	$6,216.00
United Facility/Professional Professional Modifier Low / Median / High Price $229.83 / $328.91 / $568.11	Professional		$229.83	$328.91	$568.11