Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $212.30 / $479.62 / $13,750.00	Facility		$212.30	$479.62	$13,750.00
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $77.47 / $149.21 / $221.89	Facility	52	$77.47	$149.21	$221.89
Aetna Facility/Professional Professional Modifier Low / Median / High Price $117.11 / $187.90 / $421.98	Professional		$117.11	$187.90	$421.98
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $877.58 / $1,559.22 / $11,500.00	Facility		$877.58	$1,559.22	$11,500.00
Asuris Northwest Health Facility/Professional Facility Modifier 52 Low / Median / High Price $237.38 / $421.46 / $421.46	Facility	52	$237.38	$421.46	$421.46
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $209.78 / $355.17 / $1,280.96	Professional		$209.78	$355.17	$1,280.96
Cigna Facility/Professional Facility Modifier Low / Median / High Price $388.19 / $388.19 / $646.73	Facility		$388.19	$388.19	$646.73
Cigna Facility/Professional Professional Modifier Low / Median / High Price $187.04 / $315.16 / $523.66	Professional		$187.04	$315.16	$523.66
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $170.81 / $289.26 / $548.42	Facility		$170.81	$289.26	$548.42
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $170.81 / $287.02 / $446.75	Professional		$170.81	$287.02	$446.75
Molina Facility/Professional Professional Modifier Low / Median / High Price $42.97 / $278.79 / $453.80	Professional		$42.97	$278.79	$453.80
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $221.77 / $320.93 / $350.88	Facility		$221.77	$320.93	$350.88
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $233.75 / $236.73 / $240.81	Facility		$233.75	$236.73	$240.81
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $203.47 / $294.89 / $433.93	Professional		$203.47	$294.89	$433.93
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $1,120.58 / $1,549.85 / $2,982.61	Facility		$1,120.58	$1,549.85	$2,982.61
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $201.99 / $278.94 / $400.93	Professional		$201.99	$278.94	$400.93
United Facility/Professional Facility Modifier Low / Median / High Price $190.00 / $666.00 / $6,216.00	Facility		$190.00	$666.00	$6,216.00
United Facility/Professional Professional Modifier Low / Median / High Price $218.99 / $358.79 / $500.14	Professional		$218.99	$358.79	$500.14