Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $92.89 / $1,724.82 / $5,225.18	Facility		$92.89	$1,724.82	$5,225.18
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $1,817.24 / $1,826.66 / $3,389.60	Facility	50	$1,817.24	$1,826.66	$3,389.60
Aetna Facility/Professional Professional Modifier Low / Median / High Price $52.68 / $99.77 / $224.20	Professional		$52.68	$99.77	$224.20
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $80.92 / $364.50 / $502.50	Professional	50	$80.92	$364.50	$502.50
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $63.50 / $63.50 / $64.73	Professional		$63.50	$63.50	$64.73
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $56.03 / $56.03 / $175.80	Professional	50	$56.03	$56.03	$175.80
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $106.98 / $1,959.77 / $3,825.90	Facility		$106.98	$1,959.77	$3,825.90
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 $72.01 / $132.57 / $1,340.00	Professional		$72.01	$132.57	$1,340.00
Asuris Northwest Health Facility/Professional Professional Modifier 50 Low / Median / High Price $125.40 / $126.00 / $294.20	Professional	50	$125.40	$126.00	$294.20
Cigna Facility/Professional Facility Modifier Low / Median / High Price $107.27 / $500.00 / $568.48	Facility		$107.27	$500.00	$568.48
Cigna Facility/Professional Professional Modifier Low / Median / High Price $57.86 / $110.61 / $215.59	Professional		$57.86	$110.61	$215.59
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $58.93 / $106.33 / $206.27	Facility		$58.93	$106.33	$206.27
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 $58.93 / $105.60 / $196.72	Professional		$58.93	$105.60	$196.72
Molina Facility/Professional Professional Modifier Low / Median / High Price $18.13 / $101.08 / $178.26	Professional		$18.13	$101.08	$178.26
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $87.64 / $145.75 / $155.72	Facility		$87.64	$145.75	$155.72
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $35.63 / $102.38 / $106.98	Facility		$35.63	$102.38	$106.98
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $70.38 / $109.31 / $186.70	Professional		$70.38	$109.31	$186.70
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 $66.77 / $104.41 / $183.25	Professional		$66.77	$104.41	$183.25
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 $93.75 / $138.46 / $215.83	Professional		$93.75	$138.46	$215.83
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $43.81 / $61.29 / $82.48	Professional		$43.81	$61.29	$82.48