Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $481.57 / $945.80 / $14,464.32	Facility		$481.57	$945.80	$14,464.32
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $361.18 / $523.83 / $709.35	Facility	54	$361.18	$523.83	$709.35
Aetna Facility/Professional Professional Modifier Low / Median / High Price $291.83 / $439.89 / $888.66	Professional		$291.83	$439.89	$888.66
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $392.66 / $668.30 / $11,500.00	Facility		$392.66	$668.30	$11,500.00
Asuris Northwest Health Facility/Professional Facility Modifier 54 Low / Median / High Price $628.48 / $1,120.06 / $1,120.06	Facility	54	$628.48	$1,120.06	$1,120.06
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $503.12 / $815.07 / $3,049.13	Professional		$503.12	$815.07	$3,049.13
Cigna Facility/Professional Facility Modifier Low / Median / High Price $305.39 / $500.00 / $568.48	Facility		$305.39	$500.00	$568.48
Cigna Facility/Professional Professional Modifier Low / Median / High Price $358.53 / $669.04 / $1,149.21	Professional		$358.53	$669.04	$1,149.21
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $249.41 / $560.79 / $885.71	Facility		$249.41	$560.79	$885.71
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $284.20 / $564.48 / $904.06	Professional		$284.20	$564.48	$904.06
Molina Facility/Professional Professional Modifier Low / Median / High Price $39.50 / $250.52 / $762.17	Professional		$39.50	$250.52	$762.17
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $487.06 / $682.73 / $762.46	Facility		$487.06	$682.73	$762.46
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $77.31 / $493.32 / $520.07	Facility		$77.31	$493.32	$520.07
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $520.07 / $782.21 / $953.30	Professional		$520.07	$782.21	$953.30
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $433.36 / $667.91 / $1,278.36	Facility		$433.36	$667.91	$1,278.36
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $485.82 / $698.49 / $941.31	Professional		$485.82	$698.49	$941.31
United Facility/Professional Facility Modifier Low / Median / High Price $157.00 / $546.00 / $5,793.00	Facility		$157.00	$546.00	$5,793.00
United Facility/Professional Professional Modifier Low / Median / High Price $421.48 / $565.40 / $1,059.24	Professional		$421.48	$565.40	$1,059.24
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $316.93 / $389.64 / $425.56	Professional		$316.93	$389.64	$425.56