Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $123.92 / $546.77 / $9,703.00	Facility		$123.92	$546.77	$9,703.00
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $57.47 / $95.57 / $154.52	Facility	52	$57.47	$95.57	$154.52
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $14.71 / $38.22 / $56.50	Facility	53	$14.71	$38.22	$56.50
Aetna Facility/Professional Professional Modifier Low / Median / High Price $73.55 / $123.92 / $310.50	Professional		$73.55	$123.92	$310.50
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $36.78 / $56.22 / $128.78	Professional	52	$36.78	$56.22	$128.78
Aetna Facility/Professional Professional Modifier 53 Low / Median / High Price $14.71 / $23.11 / $56.21	Professional	53	$14.71	$23.11	$56.21
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $108.28 / $147.80 / $202.54	Professional		$108.28	$147.80	$202.54
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $59.12 / $530.79 / $1,080.21	Facility		$59.12	$530.79	$1,080.21
Asuris Northwest Health Facility/Professional Facility Modifier 52 Low / Median / High Price $126.65 / $228.87 / $228.87	Facility	52	$126.65	$228.87	$228.87
Asuris Northwest Health Facility/Professional Facility Modifier 53 Low / Median / High Price $31.66 / $57.22 / $57.22	Facility	53	$31.66	$57.22	$57.22
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $115.65 / $208.43 / $753.20	Professional		$115.65	$208.43	$753.20
Cigna Facility/Professional Facility Modifier Low / Median / High Price $73.58 / $73.58 / $122.58	Facility		$73.58	$73.58	$122.58
Cigna Facility/Professional Professional Modifier Low / Median / High Price $111.83 / $181.80 / $307.70	Professional		$111.83	$181.80	$307.70
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $95.48 / $182.05 / $271.19	Facility		$95.48	$182.05	$271.19
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $101.06 / $181.48 / $254.87	Professional		$101.06	$181.48	$254.87
Molina Facility/Professional Professional Modifier Low / Median / High Price $25.91 / $167.04 / $273.41	Professional		$25.91	$167.04	$273.41
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $122.67 / $187.60 / $208.76	Facility		$122.67	$187.60	$208.76
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $59.12 / $139.07 / $139.84	Facility		$59.12	$139.07	$139.84
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $112.81 / $166.49 / $262.52	Professional		$112.81	$166.49	$262.52
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $366.18 / $564.38 / $1,080.21	Facility		$366.18	$564.38	$1,080.21
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $101.24 / $156.52 / $236.84	Professional		$101.24	$156.52	$236.84
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 $123.20 / $215.75 / $295.43	Professional		$123.20	$215.75	$295.43