Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $113.02 / $1,900.70 / $6,444.03	Facility		$113.02	$1,900.70	$6,444.03
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $56.51 / $101.06 / $211.72	Facility	52	$56.51	$101.06	$211.72
Aetna Facility/Professional Professional Modifier Low / Median / High Price $71.26 / $150.55 / $394.65	Professional		$71.26	$150.55	$394.65
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $365.45 / $1,959.77 / $5,070.50	Facility		$365.45	$1,959.77	$5,070.50
Asuris Northwest Health Facility/Professional Facility Modifier 52 Low / Median / High Price $125.82 / $233.74 / $233.74	Facility	52	$125.82	$233.74	$233.74
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $110.15 / $248.32 / $1,142.11	Professional		$110.15	$248.32	$1,142.11
Cigna Facility/Professional Facility Modifier Low / Median / High Price $466.83 / $568.48 / $880.53	Facility		$466.83	$568.48	$880.53
Cigna Facility/Professional Professional Modifier Low / Median / High Price $93.00 / $182.09 / $393.54	Professional		$93.00	$182.09	$393.54
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $96.00 / $196.23 / $648.52	Facility		$96.00	$196.23	$648.52
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $96.00 / $191.28 / $468.13	Professional		$96.00	$191.28	$468.13
Molina Facility/Professional Professional Modifier Low / Median / High Price $36.19 / $202.01 / $358.83	Professional		$36.19	$202.01	$358.83
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $150.75 / $265.60 / $302.17	Facility		$150.75	$265.60	$302.17
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $170.78 / $200.62 / $715.32	Facility		$170.78	$200.62	$715.32
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $103.30 / $192.06 / $339.79	Professional		$103.30	$192.06	$339.79
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $1,270.82 / $1,958.65 / $3,748.81	Facility		$1,270.82	$1,958.65	$3,748.81
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $100.09 / $174.17 / $326.11	Professional		$100.09	$174.17	$326.11
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 $170.72 / $234.24 / $384.27	Professional		$170.72	$234.24	$384.27
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $65.84 / $120.92 / $162.54	Professional		$65.84	$120.92	$162.54