Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $682.20 / $1,359.31 / $14,464.32	Facility		$682.20	$1,359.31	$14,464.32
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $511.65 / $756.32 / $1,019.48	Facility	54	$511.65	$756.32	$1,019.48
Aetna Facility/Professional Professional Modifier Low / Median / High Price $442.47 / $682.20 / $1,370.42	Professional		$442.47	$682.20	$1,370.42
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $507.80 / $734.04 / $11,500.00	Facility		$507.80	$734.04	$11,500.00
Asuris Northwest Health Facility/Professional Facility Modifier 54 Low / Median / High Price $873.36 / $1,572.54 / $1,572.54	Facility	54	$873.36	$1,572.54	$1,572.54
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $721.18 / $1,157.32 / $4,289.78	Professional		$721.18	$1,157.32	$4,289.78
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 $521.83 / $933.11 / $1,610.52	Professional		$521.83	$933.11	$1,610.52
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $279.33 / $810.96 / $1,258.23	Facility		$279.33	$810.96	$1,258.23
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $347.76 / $813.45 / $1,274.23	Professional		$347.76	$813.45	$1,274.23
Molina Facility/Professional Professional Modifier Low / Median / High Price $76.76 / $304.18 / $1,057.56	Professional		$76.76	$304.18	$1,057.56
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $646.01 / $984.23 / $1,076.69	Facility		$646.01	$984.23	$1,076.69
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $77.31 / $707.13 / $734.40	Facility		$77.31	$707.13	$734.40
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $734.40 / $1,112.44 / $1,373.57	Professional		$734.40	$1,112.44	$1,373.57
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $495.66 / $681.04 / $1,278.36	Facility		$495.66	$681.04	$1,278.36
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $693.68 / $994.51 / $1,325.45	Professional		$693.68	$994.51	$1,325.45
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 $630.00 / $868.42 / $1,513.34	Professional		$630.00	$868.42	$1,513.34
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $446.68 / $534.48 / $587.36	Professional		$446.68	$534.48	$587.36