Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $94.37 / $227.77 / $14,464.32	Facility		$94.37	$227.77	$14,464.32
Aetna Facility/Professional Professional Modifier Low / Median / High Price $49.64 / $91.14 / $237.67	Professional		$49.64	$91.14	$237.67
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $77.56 / $142.82 / $403.76	Professional	50	$77.56	$142.82	$403.76
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $138.16 / $138.16 / $138.16	Professional	50	$138.16	$138.16	$138.16
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $55.00 / $124.76 / $305.23	Facility		$55.00	$124.76	$305.23
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 $88.49 / $167.02 / $435.30	Professional		$88.49	$167.02	$435.30
Asuris Northwest Health Facility/Professional Professional Modifier 50 Low / Median / High Price $124.92 / $269.30 / $442.50	Professional	50	$124.92	$269.30	$442.50
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 $67.08 / $129.13 / $255.12	Professional		$67.08	$129.13	$255.12
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $64.08 / $119.35 / $212.72	Facility		$64.08	$119.35	$212.72
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 $64.08 / $120.17 / $215.26	Professional		$64.08	$120.17	$215.26
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 $101.17 / $166.16 / $182.91	Facility		$101.17	$166.16	$182.91
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $121.86 / $121.86 / $124.76	Facility		$121.86	$121.86	$124.76
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $91.42 / $135.50 / $225.05	Professional		$91.42	$135.50	$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 $82.39 / $126.50 / $220.64	Professional		$82.39	$126.50	$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 $108.79 / $144.22 / $256.51	Professional		$108.79	$144.22	$256.51
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $53.70 / $74.26 / $99.48	Professional		$53.70	$74.26	$99.48