Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $107.37 / $590.33 / $7,984.74	Facility		$107.37	$590.33	$7,984.74
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $980.98 / $1,775.25 / $3,085.42	Facility	50	$980.98	$1,775.25	$3,085.42
Aetna Facility/Professional Professional Modifier Low / Median / High Price $56.81 / $177.67 / $673.28	Professional		$56.81	$177.67	$673.28
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $81.45 / $185.91 / $663.13	Professional	50	$81.45	$185.91	$663.13
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $56.53 / $105.54 / $466.64	Professional		$56.53	$105.54	$466.64
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $84.80 / $84.80 / $158.31	Professional	50	$84.80	$84.80	$158.31
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $55.00 / $429.16 / $1,700.00	Facility		$55.00	$429.16	$1,700.00
Asuris Northwest Health Facility/Professional Facility Modifier 50 Low / Median / High Price $2,469.92 / $2,469.92 / $2,469.92	Facility	50	$2,469.92	$2,469.92	$2,469.92
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $100.79 / $420.59 / $1,779.12	Professional		$100.79	$420.59	$1,779.12
Asuris Northwest Health Facility/Professional Professional Modifier 50 Low / Median / High Price $142.69 / $669.30 / $690.74	Professional	50	$142.69	$669.30	$690.74
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 $76.22 / $189.53 / $682.65	Professional		$76.22	$189.53	$682.65
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $74.94 / $160.32 / $441.32	Facility		$74.94	$160.32	$441.32
Kaiser Permanente Facility/Professional Facility Modifier 50 Low / Median / High Price $1,908.48 / $1,908.48 / $1,908.48	Facility	50	$1,908.48	$1,908.48	$1,908.48
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $75.11 / $160.32 / $448.50	Professional		$75.11	$160.32	$448.50
Molina Facility/Professional Professional Modifier Low / Median / High Price $61.90 / $352.15 / $629.43	Professional		$61.90	$352.15	$629.43
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $114.60 / $350.88 / $482.40	Facility		$114.60	$350.88	$482.40
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $329.04 / $329.04 / $335.67	Facility		$329.04	$329.04	$335.67
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $96.64 / $193.47 / $575.14	Professional		$96.64	$193.47	$575.14
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $1,307.00 / $1,307.00 / $1,646.62	Facility		$1,307.00	$1,307.00	$1,646.62
Regence BlueShield Facility/Professional Facility Modifier 50 Low / Median / High Price $1,960.50 / $1,960.50 / $2,469.92	Facility	50	$1,960.50	$1,960.50	$2,469.92
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $93.70 / $190.09 / $544.82	Professional		$93.70	$190.09	$544.82
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 $209.57 / $316.36 / $688.74	Professional		$209.57	$316.36	$688.74
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $61.39 / $193.25 / $268.17	Professional		$61.39	$193.25	$268.17