Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $112.77 / $2,769.52 / $18,711.00	Facility		$112.77	$2,769.52	$18,711.00
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $38.15 / $67.56 / $118.84	Facility	52	$38.15	$67.56	$118.84
Aetna Facility/Professional Professional Modifier Low / Median / High Price $60.15 / $83.55 / $237.67	Professional		$60.15	$83.55	$237.67
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $86.37 / $2,525.71 / $4,941.05	Facility		$86.37	$2,525.71	$4,941.05
Asuris Northwest Health Facility/Professional Facility Modifier 52 Low / Median / High Price $1,235.85 / $2,055.60 / $2,055.60	Facility	52	$1,235.85	$2,055.60	$2,055.60
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $88.91 / $134.97 / $1,398.72	Professional		$88.91	$134.97	$1,398.72
Cigna Facility/Professional Facility Modifier Low / Median / High Price $466.83 / $568.48 / $1,132.06	Facility		$466.83	$568.48	$1,132.06
Cigna Facility/Professional Professional Modifier Low / Median / High Price $84.13 / $127.92 / $199.32	Professional		$84.13	$127.92	$199.32
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $87.79 / $170.12 / $992.78	Facility		$87.79	$170.12	$992.78
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $87.03 / $162.74 / $854.87	Professional		$87.03	$162.74	$854.87
Molina Facility/Professional Professional Modifier Low / Median / High Price $18.18 / $101.72 / $178.26	Professional		$18.18	$101.72	$178.26
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $103.95 / $126.34 / $160.80	Facility		$103.95	$126.34	$160.80
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $81.54 / $86.37 / $927.31	Facility		$81.54	$86.37	$927.31
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $94.03 / $136.94 / $171.44	Professional		$94.03	$136.94	$171.44
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $1,674.98 / $2,581.55 / $4,941.05	Facility		$1,674.98	$2,581.55	$4,941.05
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $83.16 / $121.48 / $167.36	Professional		$83.16	$121.48	$167.36
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 $76.97 / $119.73 / $184.09	Professional		$76.97	$119.73	$184.09
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $53.84 / $53.84 / $67.78	Professional		$53.84	$53.84	$67.78