Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $66.02 / $233.13 / $14,458.50	Facility		$66.02	$233.13	$14,458.50
Aetna Facility/Professional Professional Modifier Low / Median / High Price $58.93 / $116.98 / $296.35	Professional		$58.93	$116.98	$296.35
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $108.48 / $1,836.95 / $3,748.81	Facility		$108.48	$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 $97.76 / $181.92 / $1,094.00	Professional		$97.76	$181.92	$1,094.00
Asuris Northwest Health Facility/Professional Professional Modifier 50 Low / Median / High Price $186.96 / $192.95 / $438.07	Professional	50	$186.96	$192.95	$438.07
Cigna Facility/Professional Facility Modifier Low / Median / High Price $154.01 / $500.00 / $568.48	Facility		$154.01	$500.00	$568.48
Cigna Facility/Professional Professional Modifier Low / Median / High Price $81.01 / $159.12 / $313.06	Professional		$81.01	$159.12	$313.06
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $80.63 / $147.26 / $298.76	Facility		$80.63	$147.26	$298.76
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 $80.63 / $147.13 / $286.29	Professional		$80.63	$147.13	$286.29
Molina Facility/Professional Professional Modifier Low / Median / High Price $27.16 / $151.02 / $268.41	Professional		$27.16	$151.02	$268.41
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $109.98 / $192.66 / $233.16	Facility		$109.98	$192.66	$233.16
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $36.13 / $119.14 / $159.04	Facility		$36.13	$119.14	$159.04
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $101.49 / $163.69 / $276.07	Professional		$101.49	$163.69	$276.07
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 $85.02 / $135.97 / $249.52	Professional		$85.02	$135.97	$249.52
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 $96.99 / $159.40 / $336.00	Professional		$96.99	$159.40	$336.00
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $65.76 / $96.08 / $128.12	Professional		$65.76	$96.08	$128.12