Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $633.32 / $1,338.34 / $14,464.32	Facility		$633.32	$1,338.34	$14,464.32
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $474.99 / $692.92 / $1,003.76	Facility	54	$474.99	$692.92	$1,003.76
Aetna Facility/Professional Professional Modifier Low / Median / High Price $457.73 / $633.32 / $1,347.54	Professional		$457.73	$633.32	$1,347.54
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $400.01 / $685.96 / $11,500.00	Facility		$400.01	$685.96	$11,500.00
Asuris Northwest Health Facility/Professional Facility Modifier 54 Low / Median / High Price $874.78 / $1,570.45 / $1,570.45	Facility	54	$874.78	$1,570.45	$1,570.45
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $685.96 / $1,126.89 / $4,289.39	Professional		$685.96	$1,126.89	$4,289.39
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 $493.84 / $900.97 / $1,522.69	Professional		$493.84	$900.97	$1,522.69
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $279.33 / $767.59 / $1,175.79	Facility		$279.33	$767.59	$1,175.79
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $336.94 / $772.90 / $1,200.11	Professional		$336.94	$772.90	$1,200.11
Molina Facility/Professional Professional Modifier Low / Median / High Price $76.14 / $299.93 / $998.29	Professional		$76.14	$299.93	$998.29
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $657.95 / $905.17 / $1,005.67	Facility		$657.95	$905.17	$1,005.67
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $77.31 / $660.02 / $685.96	Facility		$77.31	$660.02	$685.96
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $685.96 / $1,072.01 / $1,336.16	Professional		$685.96	$1,072.01	$1,336.16
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 $673.13 / $961.09 / $1,275.61	Professional		$673.13	$961.09	$1,275.61
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 $584.59 / $805.61 / $1,406.95	Professional		$584.59	$805.61	$1,406.95
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $416.31 / $537.67 / $547.94	Professional		$416.31	$537.67	$547.94