Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $687.82 / $1,398.94 / $14,464.32	Facility		$687.82	$1,398.94	$14,464.32
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $515.87 / $765.65 / $1,049.21	Facility	54	$515.87	$765.65	$1,049.21
Aetna Facility/Professional Professional Modifier Low / Median / High Price $479.54 / $687.82 / $1,417.53	Professional		$479.54	$687.82	$1,417.53
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $400.01 / $733.95 / $11,500.00	Facility		$400.01	$733.95	$11,500.00
Asuris Northwest Health Facility/Professional Facility Modifier 54 Low / Median / High Price $912.38 / $1,639.31 / $1,639.31	Facility	54	$912.38	$1,639.31	$1,639.31
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $740.34 / $1,193.36 / $4,459.13	Professional		$740.34	$1,193.36	$4,459.13
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 $529.76 / $965.36 / $1,628.11	Professional		$529.76	$965.36	$1,628.11
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $279.33 / $811.32 / $1,283.65	Facility		$279.33	$811.32	$1,283.65
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $350.56 / $829.48 / $1,294.82	Professional		$350.56	$829.48	$1,294.82
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 $707.72 / $995.45 / $1,085.40	Facility		$707.72	$995.45	$1,085.40
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $77.31 / $713.48 / $740.34	Facility		$77.31	$713.48	$740.34
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $740.34 / $1,152.76 / $1,390.58	Professional		$740.34	$1,152.76	$1,390.58
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 $721.72 / $1,007.80 / $1,362.38	Professional		$721.72	$1,007.80	$1,362.38
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 $620.00 / $875.22 / $1,543.85	Professional		$620.00	$875.22	$1,543.85
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $451.37 / $560.15 / $594.88	Professional		$451.37	$560.15	$594.88