Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $142.62 / $390.48 / $14,464.32	Facility		$142.62	$390.48	$14,464.32
Aetna Facility/Professional Professional Modifier Low / Median / High Price $92.79 / $169.86 / $360.02	Professional		$92.79	$169.86	$360.02
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $183.71 / $1,836.95 / $3,748.81	Facility		$183.71	$1,836.95	$3,748.81
Asuris Northwest Health Facility/Professional Facility Modifier 50 Low / Median / High Price $2,245.42 / $2,939.66 / $5,687.07	Facility	50	$2,245.42	$2,939.66	$5,687.07
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $136.44 / $255.37 / $1,004.72	Professional		$136.44	$255.37	$1,004.72
Asuris Northwest Health Facility/Professional Professional Modifier 50 Low / Median / High Price $189.02 / $235.70 / $544.27	Professional	50	$189.02	$235.70	$544.27
Cigna Facility/Professional Facility Modifier Low / Median / High Price $714.97 / $870.49 / $880.53	Facility		$714.97	$870.49	$880.53
Cigna Facility/Professional Professional Modifier Low / Median / High Price $110.81 / $200.41 / $378.82	Professional		$110.81	$200.41	$378.82
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $106.48 / $201.60 / $648.52	Facility		$106.48	$201.60	$648.52
Kaiser Permanente Facility/Professional Facility Modifier 50 Low / Median / High Price $1,928.64 / $2,135.87 / $4,640.79	Facility	50	$1,928.64	$2,135.87	$4,640.79
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $106.48 / $199.19 / $428.57	Professional		$106.48	$199.19	$428.57
Molina Facility/Professional Professional Modifier Low / Median / High Price $36.70 / $200.92 / $354.81	Professional		$36.70	$200.92	$354.81
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $154.77 / $251.25 / $282.07	Facility		$154.77	$251.25	$282.07
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $183.71 / $183.92 / $715.32	Facility		$183.71	$183.92	$715.32
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $130.55 / $199.26 / $336.73	Professional		$130.55	$199.26	$336.73
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $1,430.01 / $1,958.65 / $3,748.81	Facility		$1,430.01	$1,958.65	$3,748.81
Regence BlueShield Facility/Professional Facility Modifier 50 Low / Median / High Price $2,145.02 / $2,937.98 / $5,623.22	Facility	50	$2,145.02	$2,937.98	$5,623.22
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $124.22 / $190.53 / $326.58	Professional		$124.22	$190.53	$326.58
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 $161.25 / $227.30 / $371.26	Professional		$161.25	$227.30	$371.26
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $79.23 / $109.60 / $144.75	Professional		$79.23	$109.60	$144.75