Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $206.02 / $364.80 / $14,464.32	Facility		$206.02	$364.80	$14,464.32
Aetna Facility/Professional Professional Modifier Low / Median / High Price $100.70 / $135.00 / $278.05	Professional		$100.70	$135.00	$278.05
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $150.62 / $195.48 / $891.31	Professional	50	$150.62	$195.48	$891.31
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $273.87 / $273.87 / $273.87	Professional		$273.87	$273.87	$273.87
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $360.42 / $360.42 / $360.42	Professional	50	$360.42	$360.42	$360.42
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $91.71 / $825.07 / $1,579.18	Facility		$91.71	$825.07	$1,579.18
Asuris Northwest Health Facility/Professional Facility Modifier 50 Low / Median / High Price $945.89 / $1,238.33 / $2,395.67	Facility	50	$945.89	$1,238.33	$2,395.67
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $175.70 / $293.13 / $1,199.94	Professional		$175.70	$293.13	$1,199.94
Asuris Northwest Health Facility/Professional Professional Modifier 50 Low / Median / High Price $221.13 / $351.56 / $552.00	Professional	50	$221.13	$351.56	$552.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $196.90 / $196.90 / $196.90	Facility		$196.90	$196.90	$196.90
Cigna Facility/Professional Professional Modifier Low / Median / High Price $125.22 / $208.08 / $404.50	Professional		$125.22	$208.08	$404.50
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $100.45 / $176.65 / $324.02	Facility		$100.45	$176.65	$324.02
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 $101.08 / $181.09 / $332.65	Professional		$101.08	$181.09	$332.65
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.10 / $176.10 / $318.69	Professional		$32.10	$176.10	$318.69
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $169.31 / $241.87 / $267.33	Facility		$169.31	$241.87	$267.33
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $91.71 / $176.67 / $182.34	Facility		$91.71	$176.67	$182.34
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $182.34 / $273.32 / $342.62	Professional		$182.34	$273.32	$342.62
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $535.33 / $825.55 / $1,579.18	Facility		$535.33	$825.55	$1,579.18
Regence BlueShield Facility/Professional Facility Modifier 50 Low / Median / High Price $803.00 / $1,238.33 / $2,368.77	Facility	50	$803.00	$1,238.33	$2,368.77
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $156.16 / $248.47 / $337.35	Professional		$156.16	$248.47	$337.35
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 $150.15 / $203.20 / $361.02	Professional		$150.15	$203.20	$361.02