Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $233.37 / $2,862.00 / $5,539.00	Facility		$233.37	$2,862.00	$5,539.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $1,493.85 / $3,443.49 / $6,141.39	Facility	50	$1,493.85	$3,443.49	$6,141.39
Aetna Facility/Professional Professional Modifier Low / Median / High Price $103.18 / $207.73 / $532.38	Professional		$103.18	$207.73	$532.38
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $98.04 / $333.09 / $1,381.00	Professional	50	$98.04	$333.09	$1,381.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $124.27 / $275.82 / $381.04	Professional		$124.27	$275.82	$381.04
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $150.91 / $150.91 / $386.77	Professional	50	$150.91	$150.91	$386.77
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $273.29 / $2,525.71 / $5,712.49	Facility		$273.29	$2,525.71	$5,712.49
Asuris Northwest Health Facility/Professional Facility Modifier 50 Low / Median / High Price $2,799.32 / $3,874.55 / $7,495.73	Facility	50	$2,799.32	$3,874.55	$7,495.73
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $178.14 / $338.98 / $1,012.00	Professional		$178.14	$338.98	$1,012.00
Asuris Northwest Health Facility/Professional Professional Modifier 50 Low / Median / High Price $309.18 / $555.72 / $610.50	Professional	50	$309.18	$555.72	$610.50
Cigna Facility/Professional Facility Modifier Low / Median / High Price $500.00 / $870.49 / $1,132.06	Facility		$500.00	$870.49	$1,132.06
Cigna Facility/Professional Professional Modifier Low / Median / High Price $135.78 / $269.69 / $536.08	Professional		$135.78	$269.69	$536.08
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $138.99 / $265.30 / $840.73	Facility		$138.99	$265.30	$840.73
Kaiser Permanente Facility/Professional Facility Modifier 50 Low / Median / High Price $1,907.75 / $2,550.75 / $5,846.21	Facility	50	$1,907.75	$2,550.75	$5,846.21
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $138.99 / $263.12 / $619.97	Professional		$138.99	$263.12	$619.97
Molina Facility/Professional Professional Modifier Low / Median / High Price $54.29 / $302.18 / $536.42	Professional		$54.29	$302.18	$536.42
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $204.35 / $358.45 / $387.93	Facility		$204.35	$358.45	$387.93
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $258.20 / $264.60 / $927.31	Facility		$258.20	$264.60	$927.31
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $175.96 / $273.64 / $475.10	Professional		$175.96	$273.64	$475.10
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $1,674.98 / $2,581.55 / $4,941.05	Facility		$1,674.98	$2,581.55	$4,941.05
Regence BlueShield Facility/Professional Facility Modifier 50 Low / Median / High Price $2,512.46 / $3,872.33 / $7,411.58	Facility	50	$2,512.46	$3,872.33	$7,411.58
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $166.94 / $263.33 / $472.68	Professional		$166.94	$263.33	$472.68
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 $233.07 / $352.09 / $550.34	Professional		$233.07	$352.09	$550.34
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $112.26 / $159.02 / $214.87	Professional		$112.26	$159.02	$214.87