Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $583.51 / $1,202.23 / $9,703.00	Facility		$583.51	$1,202.23	$9,703.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $464.46 / $679.78 / $914.60	Facility	54	$464.46	$679.78	$914.60
Aetna Facility/Professional Professional Modifier Low / Median / High Price $394.93 / $603.85 / $1,202.23	Professional		$394.93	$603.85	$1,202.23
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $1,446.27 / $4,554.63 / $11,500.00	Facility		$1,446.27	$4,554.63	$11,500.00
Asuris Northwest Health Facility/Professional Facility Modifier 54 Low / Median / High Price $788.22 / $1,415.72 / $1,415.72	Facility	54	$788.22	$1,415.72	$1,415.72
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $654.65 / $1,054.16 / $3,863.33	Professional		$654.65	$1,054.16	$3,863.33
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 $466.04 / $841.70 / $1,473.17	Professional		$466.04	$841.70	$1,473.17
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $448.57 / $892.44 / $1,472.45	Facility		$448.57	$892.44	$1,472.45
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $448.57 / $877.50 / $1,378.59	Professional		$448.57	$877.50	$1,378.59
Molina Facility/Professional Professional Modifier Low / Median / High Price $76.14 / $299.19 / $981.09	Professional		$76.14	$299.19	$981.09
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $643.41 / $889.76 / $988.92	Facility		$643.41	$889.76	$988.92
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $537.44 / $641.90 / $1,613.81	Facility		$537.44	$641.90	$1,613.81
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $674.53 / $994.50 / $1,238.95	Professional		$674.53	$994.50	$1,238.95
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 $641.60 / $907.31 / $1,217.40	Professional		$641.60	$907.31	$1,217.40
United Facility/Professional Facility Modifier Low / Median / High Price $472.00 / $938.00 / $4,611.00	Facility		$472.00	$938.00	$4,611.00
United Facility/Professional Professional Modifier Low / Median / High Price $579.64 / $795.32 / $1,402.87	Professional		$579.64	$795.32	$1,402.87
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $410.24 / $484.06 / $543.26	Professional		$410.24	$484.06	$543.26