Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $110.35 / $267.43 / $12,214.00	Facility		$110.35	$267.43	$12,214.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $58.59 / $100.42 / $264.43	Professional		$58.59	$100.42	$264.43
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $130.26 / $211.29 / $457.57	Professional	50	$130.26	$211.29	$457.57
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $55.00 / $133.90 / $335.37	Facility		$55.00	$133.90	$335.37
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $102.31 / $177.65 / $575.00	Professional		$102.31	$177.65	$575.00
Asuris Northwest Health Facility/Professional Professional Modifier 50 Low / Median / High Price $159.21 / $180.89 / $348.00	Professional	50	$159.21	$180.89	$348.00
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 $77.77 / $144.94 / $274.08	Professional		$77.77	$144.94	$274.08
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $74.27 / $134.80 / $230.79	Facility		$74.27	$134.80	$230.79
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $74.62 / $135.91 / $231.11	Professional		$74.62	$135.91	$231.11
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 $117.25 / $181.20 / $196.31	Facility		$117.25	$181.20	$196.31
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $130.46 / $130.46 / $133.90	Facility		$130.46	$130.46	$133.90
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $99.90 / $150.61 / $242.55	Professional		$99.90	$150.61	$242.55
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 Professional Modifier Low / Median / High Price $95.85 / $147.63 / $236.66	Professional		$95.85	$147.63	$236.66
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 $117.83 / $160.05 / $275.25	Professional		$117.83	$160.05	$275.25
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $62.57 / $80.61 / $107.17	Professional		$62.57	$80.61	$107.17