Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $664.16 / $1,413.78 / $13,750.00	Facility		$664.16	$1,413.78	$13,750.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $498.12 / $726.98 / $980.09	Facility	54	$498.12	$726.98	$980.09
Aetna Facility/Professional Professional Modifier Low / Median / High Price $433.33 / $664.16 / $1,347.07	Professional		$433.33	$664.16	$1,347.07
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $1,613.81 / $4,554.63 / $11,500.00	Facility		$1,613.81	$4,554.63	$11,500.00
Asuris Northwest Health Facility/Professional Facility Modifier 54 Low / Median / High Price $833.66 / $1,496.25 / $1,496.25	Facility	54	$833.66	$1,496.25	$1,496.25
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $699.47 / $1,121.29 / $4,086.45	Professional		$699.47	$1,121.29	$4,086.45
Cigna Facility/Professional Facility Modifier Low / Median / High Price $466.83 / $568.48 / $1,985.59	Facility		$466.83	$568.48	$1,985.59
Cigna Facility/Professional Professional Modifier Low / Median / High Price $498.05 / $890.88 / $1,561.28	Professional		$498.05	$890.88	$1,561.28
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $468.93 / $939.41 / $1,490.07	Facility		$468.93	$939.41	$1,490.07
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $469.37 / $934.56 / $1,462.47	Professional		$469.37	$934.56	$1,462.47
Molina Facility/Professional Professional Modifier Low / Median / High Price $76.14 / $299.56 / $998.95	Professional		$76.14	$299.56	$998.95
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $688.47 / $952.07 / $1,051.90	Facility		$688.47	$952.07	$1,051.90
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $537.44 / $685.84 / $1,613.81	Facility		$537.44	$685.84	$1,613.81
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $717.49 / $1,053.33 / $1,315.03	Professional		$717.49	$1,053.33	$1,315.03
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $2,953.48 / $4,552.03 / $8,712.50	Facility		$2,953.48	$4,552.03	$8,712.50
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $678.35 / $964.99 / $1,291.58	Professional		$678.35	$964.99	$1,291.58
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 $609.00 / $788.69 / $1,465.85	Professional		$609.00	$788.69	$1,465.85
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $435.91 / $513.29 / $579.20	Professional		$435.91	$513.29	$579.20