Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $59.93 / $126.57 / $5,128.00	Facility		$59.93	$126.57	$5,128.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $51.70 / $254.52 / $954.50	Facility	50	$51.70	$254.52	$954.50
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $21.09 / $42.34 / $64.03	Facility	52	$21.09	$42.34	$64.03
Aetna Facility/Professional Professional Modifier Low / Median / High Price $29.28 / $60.30 / $139.16	Professional		$29.28	$60.30	$139.16
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $42.06 / $97.64 / $284.70	Professional	50	$42.06	$97.64	$284.70
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $14.79 / $29.38 / $54.79	Professional	52	$14.79	$29.38	$54.79
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $47.25 / $80.33 / $97.13	Professional		$47.25	$80.33	$97.13
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $85.16 / $85.16 / $85.16	Professional	50	$85.16	$85.16	$85.16
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $63.42 / $173.34 / $331.58	Facility		$63.42	$173.34	$331.58
Asuris Northwest Health Facility/Professional Facility Modifier 50 Low / Median / High Price $216.72 / $216.72 / $216.72	Facility	50	$216.72	$216.72	$216.72
Asuris Northwest Health Facility/Professional Facility Modifier 52 Low / Median / High Price $65.76 / $116.25 / $116.25	Facility	52	$65.76	$116.25	$116.25
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $56.02 / $98.64 / $356.96	Professional		$56.02	$98.64	$356.96
Asuris Northwest Health Facility/Professional Professional Modifier 50 Low / Median / High Price $44.81 / $64.68 / $139.13	Professional	50	$44.81	$64.68	$139.13
Cigna Facility/Professional Professional Modifier Low / Median / High Price $52.14 / $85.98 / $145.00	Professional		$52.14	$85.98	$145.00
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $43.70 / $73.40 / $133.60	Facility		$43.70	$73.40	$133.60
Kaiser Permanente Facility/Professional Facility Modifier 50 Low / Median / High Price $168.74 / $207.45 / $499.13	Facility	50	$168.74	$207.45	$499.13
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $46.19 / $73.40 / $117.41	Professional		$46.19	$73.40	$117.41
Molina Facility/Professional Professional Modifier Low / Median / High Price $17.06 / $110.93 / $180.72	Professional		$17.06	$110.93	$180.72
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $62.38 / $91.00 / $96.48	Facility		$62.38	$91.00	$96.48
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $63.42 / $63.42 / $65.81	Facility		$63.42	$63.42	$65.81
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $55.75 / $82.76 / $120.63	Professional		$55.75	$82.76	$120.63
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $126.49 / $173.34 / $331.58	Facility		$126.49	$173.34	$331.58
Regence BlueShield Facility/Professional Facility Modifier 50 Low / Median / High Price $172.02 / $172.02 / $216.72	Facility	50	$172.02	$172.02	$216.72
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $52.23 / $75.31 / $111.46	Professional		$52.23	$75.31	$111.46
United Facility/Professional Facility Modifier Low / Median / High Price $190.00 / $666.00 / $6,216.00	Facility		$190.00	$666.00	$6,216.00
United Facility/Professional Professional Modifier Low / Median / High Price $59.84 / $100.12 / $137.10	Professional		$59.84	$100.12	$137.10