Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $702.99 / $1,399.80 / $12,214.00	Facility		$702.99	$1,399.80	$12,214.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $527.24 / $829.34 / $1,050.98	Facility	54	$527.24	$829.34	$1,050.98
Aetna Facility/Professional Professional Modifier Low / Median / High Price $455.06 / $637.83 / $1,335.68	Professional		$455.06	$637.83	$1,335.68
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $2,029.23 / $4,554.63 / $11,500.00	Facility		$2,029.23	$4,554.63	$11,500.00
Asuris Northwest Health Facility/Professional Facility Modifier 54 Low / Median / High Price $895.27 / $1,610.71 / $1,610.71	Facility	54	$895.27	$1,610.71	$1,610.71
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $741.97 / $1,188.44 / $4,395.30	Professional		$741.97	$1,188.44	$4,395.30
Cigna Facility/Professional Facility Modifier Low / Median / High Price $466.83 / $568.48 / $1,985.59	Facility		$466.83	$568.48	$1,985.59
Cigna Facility/Professional Professional Modifier Low / Median / High Price $536.39 / $956.75 / $1,660.25	Professional		$536.39	$956.75	$1,660.25
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $514.60 / $1,028.15 / $1,528.97	Facility		$514.60	$1,028.15	$1,528.97
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $513.60 / $1,021.92 / $1,490.07	Professional		$513.60	$1,021.92	$1,490.07
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 $742.25 / $1,021.75 / $1,108.84	Facility		$742.25	$1,021.75	$1,108.84
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $537.44 / $727.52 / $1,613.81	Facility		$537.44	$727.52	$1,613.81
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $756.34 / $1,137.55 / $1,411.65	Professional		$756.34	$1,137.55	$1,411.65
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $2,953.48 / $4,552.03 / $8,712.50	Facility		$2,953.48	$4,552.03	$8,712.50
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $730.09 / $1,023.18 / $1,365.04	Professional		$730.09	$1,023.18	$1,365.04
United Facility/Professional Facility Modifier Low / Median / High Price $702.00 / $1,436.00 / $6,857.00	Facility		$702.00	$1,436.00	$6,857.00
United Facility/Professional Professional Modifier Low / Median / High Price $661.09 / $899.79 / $1,554.19	Professional		$661.09	$899.79	$1,554.19
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $459.65 / $548.86 / $606.08	Professional		$459.65	$548.86	$606.08