Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $266.94 / $525.44 / $12,214.00	Facility		$266.94	$525.44	$12,214.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $200.21 / $292.23 / $394.08	Facility	54	$200.21	$292.23	$394.08
Aetna Facility/Professional Professional Modifier Low / Median / High Price $163.97 / $249.22 / $514.76	Professional		$163.97	$249.22	$514.76
Aetna Facility/Professional Professional Modifier 54 Low / Median / High Price $135.19 / $202.69 / $408.43	Professional	54	$135.19	$202.69	$408.43
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $232.18 / $668.30 / $1,477.97	Facility		$232.18	$668.30	$1,477.97
Asuris Northwest Health Facility/Professional Facility Modifier 54 Low / Median / High Price $360.53 / $641.12 / $641.12	Facility	54	$360.53	$641.12	$641.12
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $280.04 / $458.87 / $1,736.33	Professional		$280.04	$458.87	$1,736.33
Asuris Northwest Health Facility/Professional Professional Modifier 54 Low / Median / High Price $303.52 / $378.48 / $378.48	Professional	54	$303.52	$378.48	$378.48
Cigna Facility/Professional Facility Modifier Low / Median / High Price $305.39 / $305.39 / $305.39	Facility		$305.39	$305.39	$305.39
Cigna Facility/Professional Professional Modifier Low / Median / High Price $199.67 / $377.85 / $642.54	Professional		$199.67	$377.85	$642.54
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $179.55 / $318.70 / $502.49	Facility		$179.55	$318.70	$502.49
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $179.55 / $322.99 / $502.49	Professional		$179.55	$322.99	$502.49
Molina Facility/Professional Professional Modifier Low / Median / High Price $31.89 / $153.41 / $427.59	Professional		$31.89	$153.41	$427.59
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $261.00 / $376.54 / $425.45	Facility		$261.00	$376.54	$425.45
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $77.31 / $272.70 / $290.20	Facility		$77.31	$272.70	$290.20
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $290.20 / $440.66 / $541.54	Professional		$290.20	$440.66	$541.54
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 $273.60 / $392.46 / $523.75	Professional		$273.60	$392.46	$523.75
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 $234.50 / $322.62 / $599.58	Professional		$234.50	$322.62	$599.58
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $177.79 / $224.52 / $239.91	Professional		$177.79	$224.52	$239.91