Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $413.00 / $792.51 / $13,750.00	Facility		$413.00	$792.51	$13,750.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $309.75 / $448.10 / $608.09	Facility	54	$309.75	$448.10	$608.09
Aetna Facility/Professional Professional Modifier Low / Median / High Price $261.02 / $385.10 / $792.51	Professional		$261.02	$385.10	$792.51
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $400.01 / $668.30 / $11,500.00	Facility		$400.01	$668.30	$11,500.00
Asuris Northwest Health Facility/Professional Facility Modifier 54 Low / Median / High Price $537.58 / $956.89 / $956.89	Facility	54	$537.58	$956.89	$956.89
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $431.05 / $695.72 / $2,591.33	Professional		$431.05	$695.72	$2,591.33
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 $306.72 / $570.30 / $979.90	Professional		$306.72	$570.30	$979.90
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $235.16 / $479.60 / $761.50	Facility		$235.16	$479.60	$761.50
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $248.75 / $487.20 / $773.29	Professional		$248.75	$487.20	$773.29
Molina Facility/Professional Professional Modifier Low / Median / High Price $38.47 / $182.17 / $611.84	Professional		$38.47	$182.17	$611.84
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $382.95 / $580.89 / $649.23	Facility		$382.95	$580.89	$649.23
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $77.31 / $422.65 / $442.83	Facility		$77.31	$422.65	$442.83
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $442.83 / $667.31 / $812.98	Professional		$442.83	$667.31	$812.98
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 $415.24 / $596.01 / $801.19	Professional		$415.24	$596.01	$801.19
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 $362.50 / $501.60 / $920.14	Professional		$362.50	$501.60	$920.14
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $270.82 / $333.62 / $364.40	Professional		$270.82	$333.62	$364.40