Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $107.84 / $266.41 / $9,703.00	Facility		$107.84	$266.41	$9,703.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $148.28 / $1,253.68 / $6,340.00	Facility	50	$148.28	$1,253.68	$6,340.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $57.53 / $107.82 / $307.68	Professional		$57.53	$107.82	$307.68
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $82.64 / $139.91 / $452.01	Professional	50	$82.64	$139.91	$452.01
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $70.04 / $70.04 / $192.66	Professional		$70.04	$70.04	$192.66
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $85.80 / $85.80 / $193.39	Professional	50	$85.80	$85.80	$193.39
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $55.00 / $133.44 / $531.49	Facility		$55.00	$133.44	$531.49
Asuris Northwest Health Facility/Professional Facility Modifier 50 Low / Median / High Price $797.24 / $797.24 / $797.24	Facility	50	$797.24	$797.24	$797.24
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $99.77 / $176.92 / $575.00	Professional		$99.77	$176.92	$575.00
Asuris Northwest Health Facility/Professional Professional Modifier 50 Low / Median / High Price $156.46 / $179.42 / $342.00	Professional	50	$156.46	$179.42	$342.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $500.00 / $714.97 / $870.49	Facility		$500.00	$714.97	$870.49
Cigna Facility/Professional Professional Modifier Low / Median / High Price $76.86 / $142.72 / $273.12	Professional		$76.86	$142.72	$273.12
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $73.42 / $133.19 / $229.38	Facility		$73.42	$133.19	$229.38
Kaiser Permanente Facility/Professional Facility Modifier 50 Low / Median / High Price $670.80 / $670.80 / $670.80	Facility	50	$670.80	$670.80	$670.80
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $73.80 / $133.51 / $230.31	Professional		$73.80	$133.51	$230.31
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 $115.37 / $177.55 / $195.64	Facility		$115.37	$177.55	$195.64
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $130.01 / $130.01 / $133.44	Facility		$130.01	$130.01	$133.44
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $98.76 / $148.97 / $240.88	Professional		$98.76	$148.97	$240.88
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $421.87 / $421.87 / $531.49	Facility		$421.87	$421.87	$531.49
Regence BlueShield Facility/Professional Facility Modifier 50 Low / Median / High Price $632.80 / $632.80 / $797.24	Facility	50	$632.80	$632.80	$797.24
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $94.24 / $145.16 / $235.85	Professional		$94.24	$145.16	$235.85
United Facility/Professional Facility Modifier Low / Median / High Price $157.00 / $546.00 / $5,793.00	Facility		$157.00	$546.00	$5,793.00
United Facility/Professional Professional Modifier Low / Median / High Price $114.24 / $158.94 / $274.54	Professional		$114.24	$158.94	$274.54
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $62.06 / $80.89 / $107.44	Professional		$62.06	$80.89	$107.44