Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,069.29 / $1,764.40 / $14,464.32	Facility		$1,069.29	$1,764.40	$14,464.32
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $683.43 / $997.64 / $1,348.07	Facility	54	$683.43	$997.64	$1,348.07
Aetna Facility/Professional Professional Modifier Low / Median / High Price $517.96 / $709.22 / $1,566.16	Professional		$517.96	$709.22	$1,566.16
Aetna Facility/Professional Professional Modifier 54 Low / Median / High Price $406.16 / $683.43 / $1,353.75	Professional	54	$406.16	$683.43	$1,353.75
Aetna Facility/Professional Professional Modifier 55 Low / Median / High Price $81.23 / $136.69 / $270.75	Professional	55	$81.23	$136.69	$270.75
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $945.99 / $2,979.68 / $7,423.29	Facility		$945.99	$2,979.68	$7,423.29
Asuris Northwest Health Facility/Professional Facility Modifier 54 Low / Median / High Price $1,094.68 / $1,904.24 / $1,904.24	Facility	54	$1,094.68	$1,904.24	$1,904.24
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $934.16 / $1,561.37 / $5,169.60	Professional		$934.16	$1,561.37	$5,169.60
Asuris Northwest Health Facility/Professional Professional Modifier 50 Low / Median / High Price $1,410.35 / $1,748.00 / $2,847.00	Professional	50	$1,410.35	$1,748.00	$2,847.00
Asuris Northwest Health Facility/Professional Professional Modifier 54 Low / Median / High Price $1,048.80 / $1,199.57 / $1,238.00	Professional	54	$1,048.80	$1,199.57	$1,238.00
Asuris Northwest Health Facility/Professional Professional Modifier 55 Low / Median / High Price $116.53 / $120.27 / $133.29	Professional	55	$116.53	$120.27	$133.29
Cigna Facility/Professional Facility Modifier Low / Median / High Price $479.00 / $479.00 / $1,174.76	Facility		$479.00	$479.00	$1,174.76
Cigna Facility/Professional Professional Modifier Low / Median / High Price $610.73 / $1,065.70 / $2,055.66	Professional		$610.73	$1,065.70	$2,055.66
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $582.46 / $912.12 / $1,714.33	Facility		$582.46	$912.12	$1,714.33
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $593.13 / $943.21 / $1,714.33	Professional		$593.13	$943.21	$1,714.33
Molina Facility/Professional Professional Modifier Low / Median / High Price $78.81 / $433.34 / $1,361.68	Professional		$78.81	$433.34	$1,361.68
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $825.43 / $1,282.70 / $1,386.90	Facility		$825.43	$1,282.70	$1,386.90
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $635.97 / $915.97 / $945.99	Facility		$635.97	$915.97	$945.99
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $945.99 / $1,405.09 / $1,775.39	Professional		$945.99	$1,405.09	$1,775.39
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $2,093.56 / $2,867.49 / $5,488.32	Facility		$2,093.56	$2,867.49	$5,488.32
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $805.73 / $1,288.22 / $1,779.42	Professional		$805.73	$1,288.22	$1,779.42
United Facility/Professional Facility Modifier Low / Median / High Price $500.00 / $1,050.00 / $6,857.00	Facility		$500.00	$1,050.00	$6,857.00
United Facility/Professional Professional Modifier Low / Median / High Price $784.37 / $1,066.00 / $1,870.82	Professional		$784.37	$1,066.00	$1,870.82