Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $100.67 / $374.90 / $12,214.00	Facility		$100.67	$374.90	$12,214.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $68.83 / $135.51 / $299.67	Professional		$68.83	$135.51	$299.67
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $204.82 / $715.80 / $737.28	Professional	50	$204.82	$715.80	$737.28
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $150.85 / $1,916.28 / $3,748.81	Facility		$150.85	$1,916.28	$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 $92.31 / $170.95 / $1,367.00	Professional		$92.31	$170.95	$1,367.00
Asuris Northwest Health Facility/Professional Professional Modifier 50 Low / Median / High Price $196.50 / $326.07 / $471.85	Professional	50	$196.50	$326.07	$471.85
Cigna Facility/Professional Facility Modifier Low / Median / High Price $167.03 / $500.00 / $568.48	Facility		$167.03	$500.00	$568.48
Cigna Facility/Professional Professional Modifier Low / Median / High Price $92.57 / $162.07 / $312.29	Professional		$92.57	$162.07	$312.29
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $105.37 / $185.18 / $333.61	Facility		$105.37	$185.18	$333.61
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 $105.37 / $180.23 / $312.98	Professional		$105.37	$180.23	$312.98
Molina Facility/Professional Professional Modifier Low / Median / High Price $27.14 / $151.02 / $268.41	Professional		$27.14	$151.02	$268.41
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $160.30 / $215.01 / $250.58	Facility		$160.30	$215.01	$250.58
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $55.95 / $150.85 / $168.00	Facility		$55.95	$150.85	$168.00
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $93.10 / $151.72 / $275.89	Professional		$93.10	$151.72	$275.89
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 $87.24 / $153.85 / $272.41	Professional		$87.24	$153.85	$272.41
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 $137.18 / $187.09 / $314.45	Professional		$137.18	$187.09	$314.45
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $57.41 / $90.55 / $122.53	Professional		$57.41	$90.55	$122.53