Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $110.41 / $1,831.52 / $10,122.46	Facility		$110.41	$1,831.52	$10,122.46
Aetna Facility/Professional Professional Modifier Low / Median / High Price $89.10 / $929.62 / $2,432.19	Professional		$89.10	$929.62	$2,432.19
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $55.00 / $1,627.60 / $1,627.60	Facility		$55.00	$1,627.60	$1,627.60
Asuris Northwest Health Facility/Professional Facility Modifier 62 Low / Median / High Price $133.97 / $246.93 / $246.93	Facility	62	$133.97	$246.93	$246.93
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $156.94 / $1,807.10 / $6,834.64	Professional		$156.94	$1,807.10	$6,834.64
Asuris Northwest Health Facility/Professional Professional Modifier 50 Low / Median / High Price $181.08 / $1,709.95 / $2,603.57	Professional	50	$181.08	$1,709.95	$2,603.57
Asuris Northwest Health Facility/Professional Professional Modifier 80 Low / Median / High Price $26.45 / $222.71 / $277.70	Professional	80	$26.45	$222.71	$277.70
Asuris Northwest Health Facility/Professional Professional Modifier AS Low / Median / High Price $22.48 / $189.31 / $236.06	Professional	AS	$22.48	$189.31	$236.06
Cigna Facility/Professional Facility Modifier Low / Median / High Price $870.49 / $870.49 / $870.49	Facility		$870.49	$870.49	$870.49
Cigna Facility/Professional Professional Modifier Low / Median / High Price $119.31 / $340.98 / $2,900.27	Professional		$119.31	$340.98	$2,900.27
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $111.61 / $1,125.13 / $3,451.56	Facility		$111.61	$1,125.13	$3,451.56
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $113.87 / $1,121.40 / $3,296.51	Professional		$113.87	$1,121.40	$3,296.51
Molina Facility/Professional Professional Modifier Low / Median / High Price $235.80 / $1,411.23 / $2,393.19	Professional		$235.80	$1,411.23	$2,393.19
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $877.54 / $1,750.66 / $2,244.00	Facility		$877.54	$1,750.66	$2,244.00
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,272.75 / $1,272.75 / $1,343.15	Facility		$1,272.75	$1,272.75	$1,343.15
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $154.60 / $387.85 / $2,590.17	Professional		$154.60	$387.85	$2,590.17
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $154.12 / $322.79 / $2,384.59	Professional		$154.12	$322.79	$2,384.59
United Facility/Professional Facility Modifier Low / Median / High Price $295.00 / $648.00 / $6,216.00	Facility		$295.00	$648.00	$6,216.00
United Facility/Professional Professional Modifier Low / Median / High Price $1,364.89 / $2,075.17 / $3,289.88	Professional		$1,364.89	$2,075.17	$3,289.88
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $88.42 / $88.42 / $1,035.13	Professional		$88.42	$88.42	$1,035.13