Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $324.95 / $1,531.21 / $18,711.00	Facility		$324.95	$1,531.21	$18,711.00
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $115.25 / $263.64 / $794.03	Facility	52	$115.25	$263.64	$794.03
Aetna Facility/Professional Professional Modifier Low / Median / High Price $181.21 / $479.54 / $1,011.29	Professional		$181.21	$479.54	$1,011.29
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $90.61 / $239.77 / $577.20	Professional	52	$90.61	$239.77	$577.20
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $798.84 / $8,490.57 / $17,279.07	Facility		$798.84	$8,490.57	$17,279.07
Asuris Northwest Health Facility/Professional Facility Modifier 52 Low / Median / High Price $363.60 / $644.26 / $644.26	Facility	52	$363.60	$644.26	$644.26
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $306.22 / $1,086.47 / $5,049.30	Professional		$306.22	$1,086.47	$5,049.30
Cigna Facility/Professional Facility Modifier Low / Median / High Price $997.54 / $997.54 / $997.54	Facility		$997.54	$997.54	$997.54
Cigna Facility/Professional Professional Modifier Low / Median / High Price $268.02 / $579.19 / $1,779.42	Professional		$268.02	$579.19	$1,779.42
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $288.30 / $672.10 / $1,945.31	Facility		$288.30	$672.10	$1,945.31
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $284.13 / $580.01 / $1,474.34	Professional		$284.13	$580.01	$1,474.34
Molina Facility/Professional Professional Modifier Low / Median / High Price $147.80 / $910.17 / $1,496.77	Professional		$147.80	$910.17	$1,496.77
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $363.88 / $1,106.17 / $1,249.83	Facility		$363.88	$1,106.17	$1,249.83
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $798.84 / $798.84 / $832.61	Facility		$798.84	$798.84	$832.61
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $304.02 / $588.20 / $1,464.30	Professional		$304.02	$588.20	$1,464.30
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $5,857.48 / $9,027.82 / $17,279.07	Facility		$5,857.48	$9,027.82	$17,279.07
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $284.87 / $543.02 / $1,352.95	Professional		$284.87	$543.02	$1,352.95
United Facility/Professional Facility Modifier Low / Median / High Price $2,155.00 / $6,594.00 / $12,835.00	Facility		$2,155.00	$6,594.00	$12,835.00
United Facility/Professional Professional Modifier Low / Median / High Price $751.38 / $1,001.83 / $1,721.49	Professional		$751.38	$1,001.83	$1,721.49