Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $136.72 / $936.94 / $7,920.26	Facility		$136.72	$936.94	$7,920.26
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $549.45 / $1,307.34 / $8,884.00	Facility	50	$549.45	$1,307.34	$8,884.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $90.54 / $128.51 / $325.25	Professional		$90.54	$128.51	$325.25
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $158.16 / $204.33 / $777.60	Professional	50	$158.16	$204.33	$777.60
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $110.91 / $149.72 / $228.14	Professional		$110.91	$149.72	$228.14
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $224.59 / $224.59 / $224.59	Professional	50	$224.59	$224.59	$224.59
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $101.84 / $899.60 / $1,835.89	Facility		$101.84	$899.60	$1,835.89
Asuris Northwest Health Facility/Professional Facility Modifier 50 Low / Median / High Price $1,011.81 / $1,011.81 / $1,011.81	Facility	50	$1,011.81	$1,011.81	$1,011.81
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $152.46 / $242.74 / $1,700.65	Professional		$152.46	$242.74	$1,700.65
Asuris Northwest Health Facility/Professional Professional Modifier 50 Low / Median / High Price $218.90 / $276.63 / $478.50	Professional	50	$218.90	$276.63	$478.50
Cigna Facility/Professional Facility Modifier Low / Median / High Price $138.68 / $138.68 / $479.00	Facility		$138.68	$138.68	$479.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $101.50 / $173.36 / $350.64	Professional		$101.50	$173.36	$350.64
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $70.75 / $152.77 / $272.81	Facility		$70.75	$152.77	$272.81
Kaiser Permanente Facility/Professional Facility Modifier 50 Low / Median / High Price $905.03 / $995.60 / $2,556.96	Facility	50	$905.03	$995.60	$2,556.96
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $71.19 / $156.83 / $264.14	Professional		$71.19	$156.83	$264.14
Molina Facility/Professional Professional Modifier Low / Median / High Price $27.16 / $152.09 / $264.27	Professional		$27.16	$152.09	$264.27
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $140.02 / $194.70 / $231.20	Facility		$140.02	$194.70	$231.20
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $101.84 / $149.49 / $154.01	Facility		$101.84	$149.49	$154.01
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $147.44 / $212.94 / $287.83	Professional		$147.44	$212.94	$287.83
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $674.54 / $959.75 / $1,835.89	Facility		$674.54	$959.75	$1,835.89
Regence BlueShield Facility/Professional Facility Modifier 50 Low / Median / High Price $803.12 / $803.12 / $1,011.81	Facility	50	$803.12	$803.12	$1,011.81
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $122.43 / $210.24 / $278.18	Professional		$122.43	$210.24	$278.18
United Facility/Professional Facility Modifier Low / Median / High Price $118.00 / $300.76 / $1,875.00	Facility		$118.00	$300.76	$1,875.00
United Facility/Professional Professional Modifier Low / Median / High Price $128.71 / $194.83 / $307.41	Professional		$128.71	$194.83	$307.41