Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $102.12 / $387.35 / $14,464.32	Facility		$102.12	$387.35	$14,464.32
Aetna Facility/Professional Professional Modifier Low / Median / High Price $67.48 / $122.79 / $238.37	Professional		$67.48	$122.79	$238.37
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $326.91 / $326.91 / $326.91	Professional	50	$326.91	$326.91	$326.91
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $105.48 / $1,836.95 / $3,748.81	Facility		$105.48	$1,836.95	$3,748.81
Asuris Northwest Health Facility/Professional Facility Modifier 50 Low / Median / High Price $2,191.65 / $2,939.66 / $5,687.07	Facility	50	$2,191.65	$2,939.66	$5,687.07
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $93.65 / $149.66 / $1,157.00	Professional		$93.65	$149.66	$1,157.00
Asuris Northwest Health Facility/Professional Professional Modifier 50 Low / Median / High Price $134.00 / $167.09 / $420.00	Professional	50	$134.00	$167.09	$420.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $103.44 / $500.00 / $568.48	Facility		$103.44	$500.00	$568.48
Cigna Facility/Professional Professional Modifier Low / Median / High Price $75.95 / $147.60 / $257.69	Professional		$75.95	$147.60	$257.69
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $76.70 / $155.84 / $329.90	Facility		$76.70	$155.84	$329.90
Kaiser Permanente Facility/Professional Facility Modifier 50 Low / Median / High Price $976.01 / $1,928.84 / $4,640.79	Facility	50	$976.01	$1,928.84	$4,640.79
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $76.70 / $148.69 / $289.19	Professional		$76.70	$148.69	$289.19
Molina Facility/Professional Professional Modifier Low / Median / High Price $18.21 / $101.01 / $178.11	Professional		$18.21	$101.01	$178.11
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $127.76 / $168.48 / $273.14	Facility		$127.76	$168.48	$273.14
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $35.13 / $118.36 / $118.69	Facility		$35.13	$118.36	$118.69
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $93.65 / $141.08 / $216.71	Professional		$93.65	$141.08	$216.71
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $1,270.82 / $1,958.65 / $3,748.81	Facility		$1,270.82	$1,958.65	$3,748.81
Regence BlueShield Facility/Professional Facility Modifier 50 Low / Median / High Price $1,906.23 / $2,937.98 / $5,623.22	Facility	50	$1,906.23	$2,937.98	$5,623.22
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $88.85 / $135.59 / $211.05	Professional		$88.85	$135.59	$211.05
United Facility/Professional Facility Modifier Low / Median / High Price $472.00 / $938.00 / $4,611.00	Facility		$472.00	$938.00	$4,611.00
United Facility/Professional Professional Modifier Low / Median / High Price $104.06 / $183.33 / $247.01	Professional		$104.06	$183.33	$247.01
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $57.67 / $71.22 / $93.97	Professional		$57.67	$71.22	$93.97