Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $176.92 / $300.70 / $13,750.00	Facility		$176.92	$300.70	$13,750.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $662.10 / $662.10 / $829.98	Facility	50	$662.10	$662.10	$829.98
Aetna Facility/Professional Professional Modifier Low / Median / High Price $87.76 / $157.91 / $320.97	Professional		$87.76	$157.91	$320.97
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $517.23 / $517.23 / $517.23	Professional	50	$517.23	$517.23	$517.23
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $192.12 / $786.75 / $1,605.58	Facility		$192.12	$786.75	$1,605.58
Asuris Northwest Health Facility/Professional Facility Modifier 50 Low / Median / High Price $905.78 / $1,259.03 / $2,435.71	Facility	50	$905.78	$1,259.03	$2,435.71
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $168.75 / $284.70 / $1,058.16	Professional		$168.75	$284.70	$1,058.16
Asuris Northwest Health Facility/Professional Professional Modifier 50 Low / Median / High Price $308.82 / $384.00 / $514.50	Professional	50	$308.82	$384.00	$514.50
Cigna Facility/Professional Facility Modifier Low / Median / High Price $202.26 / $500.00 / $568.48	Facility		$202.26	$500.00	$568.48
Cigna Facility/Professional Professional Modifier Low / Median / High Price $107.60 / $206.44 / $405.73	Professional		$107.60	$206.44	$405.73
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $96.72 / $177.38 / $274.70	Facility		$96.72	$177.38	$274.70
Kaiser Permanente Facility/Professional Facility Modifier 50 Low / Median / High Price $670.80 / $878.49 / $2,113.65	Facility	50	$670.80	$878.49	$2,113.65
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $96.72 / $171.87 / $274.70	Professional		$96.72	$171.87	$274.70
Molina Facility/Professional Professional Modifier Low / Median / High Price $36.60 / $201.32 / $357.49	Professional		$36.60	$201.32	$357.49
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $144.00 / $240.35 / $292.79	Facility		$144.00	$240.35	$292.79
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $63.98 / $192.53 / $199.71	Facility		$63.98	$192.53	$199.71
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $172.20 / $256.14 / $355.13	Professional		$172.20	$256.14	$355.13
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $544.28 / $838.87 / $1,605.58	Facility		$544.28	$838.87	$1,605.58
Regence BlueShield Facility/Professional Facility Modifier 50 Low / Median / High Price $816.42 / $1,258.31 / $2,408.37	Facility	50	$816.42	$1,258.31	$2,408.37
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $162.87 / $232.32 / $331.90	Professional		$162.87	$232.32	$331.90
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 $134.10 / $199.09 / $415.15	Professional		$134.10	$199.09	$415.15
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $114.26 / $121.19 / $160.83	Professional		$114.26	$121.19	$160.83