Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $153.46 / $536.20 / $11,522.02	Facility		$153.46	$536.20	$11,522.02
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $21.06 / $50.14 / $100.31	Facility	53	$21.06	$50.14	$100.31
Aetna Facility/Professional Professional Modifier Low / Median / High Price $77.25 / $194.78 / $475.04	Professional		$77.25	$194.78	$475.04
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $112.51 / $112.51 / $112.51	Professional		$112.51	$112.51	$112.51
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $55.00 / $580.01 / $702.04	Facility		$55.00	$580.01	$702.04
Asuris Northwest Health Facility/Professional Facility Modifier 53 Low / Median / High Price $42.50 / $74.79 / $74.79	Facility	53	$42.50	$74.79	$74.79
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $143.16 / $363.85 / $1,553.44	Professional		$143.16	$363.85	$1,553.44
Cigna Facility/Professional Professional Modifier Low / Median / High Price $105.85 / $233.11 / $527.17	Professional		$105.85	$233.11	$527.17
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $113.41 / $211.80 / $499.52	Facility		$113.41	$211.80	$499.52
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $118.56 / $220.94 / $497.35	Professional		$118.56	$220.94	$497.35
Molina Facility/Professional Professional Modifier Low / Median / High Price $54.29 / $323.83 / $546.52	Professional		$54.29	$323.83	$546.52
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $181.39 / $356.44 / $379.22	Facility		$181.39	$356.44	$379.22
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $255.92 / $255.92 / $264.10	Facility		$255.92	$255.92	$264.10
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $146.84 / $255.92 / $507.98	Professional		$146.84	$255.92	$507.98
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $149.08 / $269.35 / $434.84	Professional		$149.08	$269.35	$434.84
United Facility/Professional Facility Modifier Low / Median / High Price $414.00 / $666.00 / $6,216.00	Facility		$414.00	$666.00	$6,216.00
United Facility/Professional Professional Modifier Low / Median / High Price $220.74 / $365.64 / $557.52	Professional		$220.74	$365.64	$557.52
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $86.76 / $86.76 / $206.33	Professional		$86.76	$86.76	$206.33