Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $243.78 / $954.50 / $5,116.62	Facility		$243.78	$954.50	$5,116.62
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $177.51 / $305.51 / $405.75	Facility	54	$177.51	$305.51	$405.75
Aetna Facility/Professional Professional Modifier Low / Median / High Price $144.28 / $236.68 / $540.09	Professional		$144.28	$236.68	$540.09
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $142.05 / $1,104.92 / $2,206.01	Facility		$142.05	$1,104.92	$2,206.01
Asuris Northwest Health Facility/Professional Facility Modifier 54 Low / Median / High Price $334.50 / $451.94 / $589.19	Facility	54	$334.50	$451.94	$589.19
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $254.09 / $464.88 / $1,602.24	Professional		$254.09	$464.88	$1,602.24
Asuris Northwest Health Facility/Professional Professional Modifier 50 Low / Median / High Price $339.74 / $640.04 / $640.04	Professional	50	$339.74	$640.04	$640.04
Cigna Facility/Professional Facility Modifier Low / Median / High Price $185.95 / $421.10 / $731.00	Facility		$185.95	$421.10	$731.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $222.44 / $334.01 / $619.57	Professional		$222.44	$334.01	$619.57
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $197.47 / $322.20 / $509.84	Facility		$197.47	$322.20	$509.84
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $200.43 / $338.10 / $532.04	Professional		$200.43	$338.10	$532.04
Molina Facility/Professional Professional Modifier Low / Median / High Price $49.65 / $279.63 / $494.90	Professional		$49.65	$279.63	$494.90
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $169.69 / $269.06 / $420.84	Facility		$169.69	$269.06	$420.84
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $104.79 / $286.30 / $295.68	Facility		$104.79	$286.30	$295.68
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $261.32 / $423.84 / $541.99	Professional		$261.32	$423.84	$541.99
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $732.75 / $1,129.34 / $2,161.55	Facility		$732.75	$1,129.34	$2,161.55
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $248.18 / $354.13 / $513.44	Professional		$248.18	$354.13	$513.44
United Facility/Professional Facility Modifier Low / Median / High Price $140.00 / $588.00 / $5,793.00	Facility		$140.00	$588.00	$5,793.00
United Facility/Professional Professional Modifier Low / Median / High Price $237.97 / $297.00 / $605.15	Professional		$237.97	$297.00	$605.15
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $201.82 / $201.82 / $236.55	Professional		$201.82	$201.82	$236.55