Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $77.23 / $276.32 / $14,464.32	Facility		$77.23	$276.32	$14,464.32
Aetna Facility/Professional Professional Modifier Low / Median / High Price $55.02 / $79.38 / $171.92	Professional		$55.02	$79.38	$171.92
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $225.04 / $225.04 / $225.04	Professional	50	$225.04	$225.04	$225.04
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $67.43 / $67.43 / $67.43	Professional		$67.43	$67.43	$67.43
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $55.00 / $773.81 / $1,579.18	Facility		$55.00	$773.81	$1,579.18
Asuris Northwest Health Facility/Professional Facility Modifier 50 Low / Median / High Price $962.58 / $1,238.33 / $2,395.67	Facility	50	$962.58	$1,238.33	$2,395.67
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $70.22 / $121.37 / $425.33	Professional		$70.22	$121.37	$425.33
Asuris Northwest Health Facility/Professional Professional Modifier 50 Low / Median / High Price $111.05 / $141.05 / $216.00	Professional	50	$111.05	$141.05	$216.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $55.17 / $55.17 / $479.00	Facility		$55.17	$55.17	$479.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $56.84 / $113.27 / $164.99	Professional		$56.84	$113.27	$164.99
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $28.14 / $120.50 / $230.23	Facility		$28.14	$120.50	$230.23
Kaiser Permanente Facility/Professional Facility Modifier 50 Low / Median / High Price $720.25 / $792.33 / $2,456.67	Facility	50	$720.25	$792.33	$2,456.67
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $28.31 / $121.00 / $223.64	Professional		$28.31	$121.00	$223.64
Molina Facility/Professional Professional Modifier Low / Median / High Price $18.18 / $101.83 / $176.59	Professional		$18.18	$101.83	$176.59
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $83.54 / $114.57 / $189.75	Facility		$83.54	$114.57	$189.75
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $34.75 / $68.86 / $69.92	Facility		$34.75	$68.86	$69.92
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $69.92 / $108.34 / $132.33	Professional		$69.92	$108.34	$132.33
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $602.39 / $825.55 / $1,579.18	Facility		$602.39	$825.55	$1,579.18
Regence BlueShield Facility/Professional Facility Modifier 50 Low / Median / High Price $903.59 / $1,238.33 / $2,368.77	Facility	50	$903.59	$1,238.33	$2,368.77
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $63.29 / $99.05 / $142.68	Professional		$63.29	$99.05	$142.68
United Facility/Professional Facility Modifier Low / Median / High Price $118.00 / $414.00 / $5,793.00	Facility		$118.00	$414.00	$5,793.00
United Facility/Professional Professional Modifier Low / Median / High Price $72.40 / $109.33 / $160.90	Professional		$72.40	$109.33	$160.90