Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $762.51 / $5,243.41 / $26,244.16	Facility		$762.51	$5,243.41	$26,244.16
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $151.66 / $235.60 / $875.30	Facility	53	$151.66	$235.60	$875.30
Aetna Facility/Professional Professional Modifier Low / Median / High Price $383.36 / $762.51 / $4,005.42	Professional		$383.36	$762.51	$4,005.42
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $3,313.26 / $19,381.37 / $28,837.85	Facility		$3,313.26	$19,381.37	$28,837.85
Asuris Northwest Health Facility/Professional Facility Modifier 53 Low / Median / High Price $214.13 / $377.84 / $377.84	Facility	53	$214.13	$377.84	$377.84
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $717.18 / $4,141.03 / $16,822.72	Professional		$717.18	$4,141.03	$16,822.72
Cigna Facility/Professional Facility Modifier Low / Median / High Price $625.25 / $2,285.42 / $12,042.65	Facility		$625.25	$2,285.42	$12,042.65
Cigna Facility/Professional Professional Modifier Low / Median / High Price $520.26 / $1,304.61 / $6,492.30	Professional		$520.26	$1,304.61	$6,492.30
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $501.21 / $1,048.72 / $9,093.99	Facility		$501.21	$1,048.72	$9,093.99
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $501.21 / $1,048.72 / $7,675.31	Professional		$501.21	$1,048.72	$7,675.31
Molina Facility/Professional Professional Modifier Low / Median / High Price $320.13 / $2,351.02 / $5,060.76	Professional		$320.13	$2,351.02	$5,060.76
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $703.87 / $3,615.81 / $4,576.10	Facility		$703.87	$3,615.81	$4,576.10
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $3,121.31 / $3,206.33 / $9,948.93	Facility		$3,121.31	$3,206.33	$9,948.93
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $681.48 / $1,380.98 / $5,721.49	Professional		$681.48	$1,380.98	$5,721.49
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $12,805.53 / $19,381.37 / $37,074.37	Facility		$12,805.53	$19,381.37	$37,074.37
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $660.74 / $2,779.53 / $5,318.93	Professional		$660.74	$2,779.53	$5,318.93
United Facility/Professional Facility Modifier Low / Median / High Price $3,028.00 / $5,547.00 / $19,271.00	Facility		$3,028.00	$5,547.00	$19,271.00
United Facility/Professional Professional Modifier Low / Median / High Price $1,884.40 / $2,979.88 / $6,562.61	Professional		$1,884.40	$2,979.88	$6,562.61
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $441.82 / $1,815.42 / $2,544.40	Professional		$441.82	$1,815.42	$2,544.40