Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $357.11 / $663.49 / $2,712.85	Facility		$357.11	$663.49	$2,712.85
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $280.63 / $415.34 / $541.03	Facility	54	$280.63	$415.34	$541.03
Aetna Facility/Professional Professional Modifier Low / Median / High Price $222.40 / $369.20 / $733.91	Professional		$222.40	$369.20	$733.91
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $191.26 / $668.30 / $1,300.00	Facility		$191.26	$668.30	$1,300.00
Asuris Northwest Health Facility/Professional Facility Modifier 54 Low / Median / High Price $494.31 / $885.90 / $885.90	Facility	54	$494.31	$885.90	$885.90
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $397.32 / $648.40 / $2,397.98	Professional		$397.32	$648.40	$2,397.98
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 $277.50 / $524.52 / $913.90	Professional		$277.50	$524.52	$913.90
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $229.17 / $432.30 / $692.86	Facility		$229.17	$432.30	$692.86
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $235.16 / $432.48 / $695.59	Professional		$235.16	$432.48	$695.59
Molina Facility/Professional Professional Modifier Low / Median / High Price $28.95 / $125.99 / $560.88	Professional		$28.95	$125.99	$560.88
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $345.84 / $522.60 / $608.36	Facility		$345.84	$522.60	$608.36
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $77.31 / $389.58 / $414.96	Facility		$77.31	$389.58	$414.96
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $414.96 / $614.04 / $760.63	Professional		$414.96	$614.04	$760.63
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 $378.02 / $554.73 / $743.48	Professional		$378.02	$554.73	$743.48
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 $336.02 / $487.85 / $856.40	Professional		$336.02	$487.85	$856.40
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $253.70 / $304.39 / $337.15	Professional		$253.70	$304.39	$337.15