Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $93.11 / $245.44 / $9,703.00	Facility		$93.11	$245.44	$9,703.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $799.05 / $1,332.00 / $4,255.42	Facility	50	$799.05	$1,332.00	$4,255.42
Aetna Facility/Professional Professional Modifier Low / Median / High Price $49.09 / $98.50 / $409.00	Professional		$49.09	$98.50	$409.00
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $70.41 / $148.52 / $430.14	Professional	50	$70.41	$148.52	$430.14
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $179.34 / $179.34 / $179.34	Professional		$179.34	$179.34	$179.34
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $73.19 / $136.81 / $201.71	Professional	50	$73.19	$136.81	$201.71
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $55.00 / $514.84 / $1,700.00	Facility		$55.00	$514.84	$1,700.00
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 $86.30 / $157.63 / $483.00	Professional		$86.30	$157.63	$483.00
Asuris Northwest Health Facility/Professional Professional Modifier 50 Low / Median / High Price $133.60 / $153.84 / $294.00	Professional	50	$133.60	$153.84	$294.00
Asuris Northwest Health Facility/Professional Professional Modifier 80 Low / Median / High Price $15.90 / $16.41 / $28.94	Professional	80	$15.90	$16.41	$28.94
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 $66.18 / $130.34 / $253.16	Professional		$66.18	$130.34	$253.16
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $63.23 / $117.81 / $211.92	Facility		$63.23	$117.81	$211.92
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 $63.23 / $119.52 / $215.26	Professional		$63.23	$119.52	$215.26
Molina Facility/Professional Professional Modifier Low / Median / High Price $27.13 / $151.02 / $268.41	Professional		$27.13	$151.02	$268.41
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $99.83 / $163.47 / $182.91	Facility		$99.83	$163.47	$182.91
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $122.31 / $122.31 / $124.76	Facility		$122.31	$122.31	$124.76
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $85.14 / $131.69 / $225.05	Professional		$85.14	$131.69	$225.05
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 $81.31 / $124.74 / $220.64	Professional		$81.31	$124.74	$220.64
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 $106.32 / $146.75 / $260.70	Professional		$106.32	$146.75	$260.70
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $53.07 / $75.09 / $100.43	Professional		$53.07	$75.09	$100.43