Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $94.61 / $645.90 / $7,984.74	Facility		$94.61	$645.90	$7,984.74
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $82.58 / $881.08 / $1,853.44	Facility	50	$82.58	$881.08	$1,853.44
Aetna Facility/Professional Professional Modifier Low / Median / High Price $65.31 / $100.34 / $268.70	Professional		$65.31	$100.34	$268.70
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $143.03 / $247.64 / $778.50	Professional	50	$143.03	$247.64	$778.50
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $136.29 / $136.29 / $164.97	Professional		$136.29	$136.29	$164.97
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $75.14 / $146.86 / $247.46	Professional	50	$75.14	$146.86	$247.46
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $103.74 / $839.35 / $4,090.18	Facility		$103.74	$839.35	$4,090.18
Asuris Northwest Health Facility/Professional Facility Modifier 50 Low / Median / High Price $961.70 / $1,273.67 / $2,435.71	Facility	50	$961.70	$1,273.67	$2,435.71
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $87.20 / $137.47 / $1,157.00	Professional		$87.20	$137.47	$1,157.00
Asuris Northwest Health Facility/Professional Professional Modifier 50 Low / Median / High Price $149.52 / $154.31 / $367.50	Professional	50	$149.52	$154.31	$367.50
Cigna Facility/Professional Facility Modifier Low / Median / High Price $85.03 / $500.00 / $568.48	Facility		$85.03	$500.00	$568.48
Cigna Facility/Professional Professional Modifier Low / Median / High Price $74.94 / $131.18 / $213.61	Professional		$74.94	$131.18	$213.61
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $64.20 / $133.60 / $250.00	Facility		$64.20	$133.60	$250.00
Kaiser Permanente Facility/Professional Facility Modifier 50 Low / Median / High Price $813.82 / $976.01 / $2,113.65	Facility	50	$813.82	$976.01	$2,113.65
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $64.20 / $131.19 / $230.35	Professional		$64.20	$131.19	$230.35
Molina Facility/Professional Professional Modifier Low / Median / High Price $18.21 / $101.08 / $178.26	Professional		$18.21	$101.08	$178.26
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $114.57 / $145.79 / $191.62	Facility		$114.57	$145.79	$191.62
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $27.35 / $101.47 / $103.74	Facility		$27.35	$101.47	$103.74
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $88.55 / $130.86 / $186.70	Professional		$88.55	$130.86	$186.70
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $641.13 / $839.35 / $1,605.58	Facility		$641.13	$839.35	$1,605.58
Regence BlueShield Facility/Professional Facility Modifier 50 Low / Median / High Price $961.70 / $1,259.03 / $2,408.37	Facility	50	$961.70	$1,259.03	$2,408.37
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $84.54 / $120.91 / $180.52	Professional		$84.54	$120.91	$180.52
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 $90.67 / $143.00 / $216.28	Professional		$90.67	$143.00	$216.28
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $54.75 / $62.67 / $81.59	Professional		$54.75	$62.67	$81.59