Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $216.97 / $588.65 / $13,750.00	Facility		$216.97	$588.65	$13,750.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $2,518.73 / $2,518.73 / $2,594.34	Facility	50	$2,518.73	$2,518.73	$2,594.34
Aetna Facility/Professional Professional Modifier Low / Median / High Price $148.72 / $226.88 / $555.25	Professional		$148.72	$226.88	$555.25
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $1,212.03 / $1,212.03 / $1,212.03	Professional	50	$1,212.03	$1,212.03	$1,212.03
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $336.58 / $2,404.65 / $4,941.05	Facility		$336.58	$2,404.65	$4,941.05
Asuris Northwest Health Facility/Professional Facility Modifier 50 Low / Median / High Price $2,799.32 / $3,874.55 / $7,495.73	Facility	50	$2,799.32	$3,874.55	$7,495.73
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $200.30 / $453.27 / $1,848.32	Professional		$200.30	$453.27	$1,848.32
Asuris Northwest Health Facility/Professional Professional Modifier 50 Low / Median / High Price $291.72 / $738.57 / $751.50	Professional	50	$291.72	$738.57	$751.50
Cigna Facility/Professional Facility Modifier Low / Median / High Price $403.00 / $500.00 / $568.48	Facility		$403.00	$500.00	$568.48
Cigna Facility/Professional Professional Modifier Low / Median / High Price $127.90 / $277.48 / $702.85	Professional		$127.90	$277.48	$702.85
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $124.88 / $234.54 / $508.14	Facility		$124.88	$234.54	$508.14
Kaiser Permanente Facility/Professional Facility Modifier 50 Low / Median / High Price $1,907.75 / $2,550.75 / $5,846.21	Facility	50	$1,907.75	$2,550.75	$5,846.21
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $124.41 / $228.25 / $458.91	Professional		$124.41	$228.25	$458.91
Molina Facility/Professional Professional Modifier Low / Median / High Price $37.39 / $203.69 / $537.05	Professional		$37.39	$203.69	$537.05
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $181.69 / $409.50 / $499.82	Facility		$181.69	$409.50	$499.82
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $131.72 / $336.58 / $395.52	Facility		$131.72	$336.58	$395.52
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $193.80 / $338.91 / $614.29	Professional		$193.80	$338.91	$614.29
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $1,674.98 / $2,581.55 / $4,941.05	Facility		$1,674.98	$2,581.55	$4,941.05
Regence BlueShield Facility/Professional Facility Modifier 50 Low / Median / High Price $2,512.46 / $3,872.33 / $7,411.58	Facility	50	$2,512.46	$3,872.33	$7,411.58
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $188.48 / $343.27 / $600.95	Professional		$188.48	$343.27	$600.95
United Facility/Professional Facility Modifier Low / Median / High Price $472.00 / $938.00 / $4,611.00	Facility		$472.00	$938.00	$4,611.00
United Facility/Professional Professional Modifier Low / Median / High Price $270.76 / $394.80 / $700.15	Professional		$270.76	$394.80	$700.15
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $129.03 / $205.67 / $280.17	Professional		$129.03	$205.67	$280.17