Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $560.79 / $1,085.24 / $13,750.00	Facility		$560.79	$1,085.24	$13,750.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $420.60 / $614.20 / $827.65	Facility	54	$420.60	$614.20	$827.65
Aetna Facility/Professional Professional Modifier Low / Median / High Price $388.58 / $560.79 / $1,103.53	Professional		$388.58	$560.79	$1,103.53
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $400.01 / $694.04 / $11,500.00	Facility		$400.01	$694.04	$11,500.00
Asuris Northwest Health Facility/Professional Facility Modifier 54 Low / Median / High Price $712.89 / $1,275.83 / $1,275.83	Facility	54	$712.89	$1,275.83	$1,275.83
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $589.97 / $944.98 / $3,472.95	Professional		$589.97	$944.98	$3,472.95
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 $420.02 / $759.49 / $1,331.27	Professional		$420.02	$759.49	$1,331.27
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $279.33 / $652.29 / $1,031.86	Facility		$279.33	$652.29	$1,031.86
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $318.70 / $660.96 / $1,054.20	Professional		$318.70	$660.96	$1,054.20
Molina Facility/Professional Professional Modifier Low / Median / High Price $39.65 / $273.26 / $898.46	Professional		$39.65	$273.26	$898.46
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $550.74 / $799.98 / $886.41	Facility		$550.74	$799.98	$886.41
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $77.31 / $578.48 / $604.61	Facility		$77.31	$578.48	$604.61
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $604.61 / $897.10 / $1,117.63	Professional		$604.61	$897.10	$1,117.63
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 $558.80 / $813.58 / $1,091.21	Professional		$558.80	$813.58	$1,091.21
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 $500.60 / $683.75 / $1,259.98	Professional		$500.60	$683.75	$1,259.98
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $368.00 / $438.00 / $488.91	Professional		$368.00	$438.00	$488.91