Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $196.67 / $654.12 / $11,522.02	Facility		$196.67	$654.12	$11,522.02
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $643.36 / $850.80 / $6,569.00	Facility	50	$643.36	$850.80	$6,569.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $97.82 / $154.87 / $335.47	Professional		$97.82	$154.87	$335.47
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $162.54 / $680.02 / $855.00	Professional	50	$162.54	$680.02	$855.00
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $375.54 / $375.54 / $375.54	Professional	50	$375.54	$375.54	$375.54
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $155.94 / $786.75 / $1,605.58	Facility		$155.94	$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 $182.53 / $281.00 / $1,000.00	Professional		$182.53	$281.00	$1,000.00
Asuris Northwest Health Facility/Professional Professional Modifier 50 Low / Median / High Price $306.18 / $400.14 / $537.00	Professional	50	$306.18	$400.14	$537.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $163.96 / $765.00 / $870.49	Facility		$163.96	$765.00	$870.49
Cigna Facility/Professional Professional Modifier Low / Median / High Price $129.18 / $220.71 / $386.86	Professional		$129.18	$220.71	$386.86
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $110.25 / $202.19 / $314.41	Facility		$110.25	$202.19	$314.41
Kaiser Permanente Facility/Professional Facility Modifier 50 Low / Median / High Price $738.07 / $878.49 / $2,113.65	Facility	50	$738.07	$878.49	$2,113.65
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $110.25 / $197.27 / $307.00	Professional		$110.25	$197.27	$307.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $38.67 / $184.72 / $375.39	Professional		$38.67	$184.72	$375.39
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $176.84 / $244.55 / $280.73	Facility		$176.84	$244.55	$280.73
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $51.93 / $185.73 / $191.48	Facility		$51.93	$185.73	$191.48
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $179.95 / $257.27 / $342.57	Professional		$179.95	$257.27	$342.57
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $588.53 / $838.87 / $1,605.58	Facility		$588.53	$838.87	$1,605.58
Regence BlueShield Facility/Professional Facility Modifier 50 Low / Median / High Price $882.80 / $1,258.31 / $2,408.37	Facility	50	$882.80	$1,258.31	$2,408.37
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $161.16 / $242.44 / $339.77	Professional		$161.16	$242.44	$339.77
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 $160.44 / $217.74 / $390.46	Professional		$160.44	$217.74	$390.46
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $115.67 / $116.48 / $150.41	Professional		$115.67	$116.48	$150.41