Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $508.97 / $1,002.72 / $13,750.00	Facility		$508.97	$1,002.72	$13,750.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $381.73 / $555.29 / $752.04	Facility	54	$381.73	$555.29	$752.04
Aetna Facility/Professional Professional Modifier Low / Median / High Price $321.75 / $479.08 / $1,017.69	Professional		$321.75	$479.08	$1,017.69
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $400.01 / $694.04 / $11,500.00	Facility		$400.01	$694.04	$11,500.00
Asuris Northwest Health Facility/Professional Facility Modifier 54 Low / Median / High Price $658.41 / $1,174.11 / $1,174.11	Facility	54	$658.41	$1,174.11	$1,174.11
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $531.29 / $858.00 / $3,196.65	Professional		$531.29	$858.00	$3,196.65
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 $380.34 / $701.12 / $1,211.22	Professional		$380.34	$701.12	$1,211.22
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $249.41 / $594.59 / $939.29	Facility		$249.41	$594.59	$939.29
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $299.88 / $598.08 / $956.53	Professional		$299.88	$598.08	$956.53
Molina Facility/Professional Professional Modifier Low / Median / High Price $39.46 / $258.87 / $824.84	Professional		$39.46	$258.87	$824.84
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $500.31 / $718.24 / $804.00	Facility		$500.31	$718.24	$804.00
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $77.31 / $520.95 / $548.40	Facility		$77.31	$520.95	$548.40
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $548.40 / $822.53 / $1,006.04	Professional		$548.40	$822.53	$1,006.04
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 $510.47 / $737.40 / $989.76	Professional		$510.47	$737.40	$989.76
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 $451.38 / $621.29 / $1,094.91	Professional		$451.38	$621.29	$1,094.91
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $334.32 / $407.57 / $448.22	Professional		$334.32	$407.57	$448.22