Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $137.69 / $954.50 / $5,539.00	Facility		$137.69	$954.50	$5,539.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $662.10 / $662.10 / $1,118.96	Facility	50	$662.10	$662.10	$1,118.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $60.67 / $111.04 / $256.82	Professional		$60.67	$111.04	$256.82
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $54.53 / $830.88 / $927.00	Professional	50	$54.53	$830.88	$927.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $84.88 / $84.88 / $151.19	Professional		$84.88	$84.88	$151.19
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $226.36 / $226.36 / $226.36	Professional	50	$226.36	$226.36	$226.36
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $111.70 / $786.75 / $1,605.58	Facility		$111.70	$786.75	$1,605.58
Asuris Northwest Health Facility/Professional Facility Modifier 50 Low / Median / High Price $905.78 / $1,259.03 / $2,435.71	Facility	50	$905.78	$1,259.03	$2,435.71
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $87.73 / $193.34 / $1,030.00	Professional		$87.73	$193.34	$1,030.00
Asuris Northwest Health Facility/Professional Professional Modifier 50 Low / Median / High Price $121.05 / $150.94 / $411.81	Professional	50	$121.05	$150.94	$411.81
Cigna Facility/Professional Facility Modifier Low / Median / High Price $184.66 / $500.00 / $568.48	Facility		$184.66	$500.00	$568.48
Cigna Facility/Professional Professional Modifier Low / Median / High Price $77.02 / $149.54 / $316.17	Professional		$77.02	$149.54	$316.17
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $83.20 / $151.69 / $304.10	Facility		$83.20	$151.69	$304.10
Kaiser Permanente Facility/Professional Facility Modifier 50 Low / Median / High Price $670.80 / $878.49 / $2,113.65	Facility	50	$670.80	$878.49	$2,113.65
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $83.20 / $150.93 / $286.22	Professional		$83.20	$150.93	$286.22
Molina Facility/Professional Professional Modifier Low / Median / High Price $27.13 / $151.02 / $268.41	Professional		$27.13	$151.02	$268.41
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $125.05 / $206.91 / $237.77	Facility		$125.05	$206.91	$237.77
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $61.22 / $153.57 / $183.83	Facility		$61.22	$153.57	$183.83
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $89.08 / $156.29 / $280.06	Professional		$89.08	$156.29	$280.06
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $544.28 / $838.87 / $1,605.58	Facility		$544.28	$838.87	$1,605.58
Regence BlueShield Facility/Professional Facility Modifier 50 Low / Median / High Price $816.42 / $1,258.31 / $2,408.37	Facility	50	$816.42	$1,258.31	$2,408.37
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $80.78 / $156.62 / $269.52	Professional		$80.78	$156.62	$269.52
United Facility/Professional Facility Modifier Low / Median / High Price $151.00 / $648.00 / $5,793.00	Facility		$151.00	$648.00	$5,793.00
United Facility/Professional Professional Modifier Low / Median / High Price $131.15 / $176.89 / $324.41	Professional		$131.15	$176.89	$324.41
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $55.17 / $93.04 / $126.20	Professional		$55.17	$93.04	$126.20