Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,487.05 / $6,320.00 / $20,680.40	Facility		$1,487.05	$6,320.00	$20,680.40
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $948.98 / $1,357.99 / $1,626.70	Facility	54	$948.98	$1,357.99	$1,626.70
Aetna Facility/Professional Professional Modifier Low / Median / High Price $641.21 / $897.76 / $1,384.45	Professional		$641.21	$897.76	$1,384.45
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $1,134.27 / $6,603.99 / $14,605.02	Facility		$1,134.27	$6,603.99	$14,605.02
Asuris Northwest Health Facility/Professional Facility Modifier 54 Low / Median / High Price $2,747.48 / $4,569.92 / $4,569.92	Facility	54	$2,747.48	$4,569.92	$4,569.92
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $1,145.06 / $2,050.92 / $7,084.73	Professional		$1,145.06	$2,050.92	$7,084.73
Cigna Facility/Professional Facility Modifier Low / Median / High Price $906.00 / $906.00 / $2,876.24	Facility		$906.00	$906.00	$2,876.24
Cigna Facility/Professional Professional Modifier Low / Median / High Price $770.35 / $1,301.41 / $2,611.79	Professional		$770.35	$1,301.41	$2,611.79
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $918.64 / $1,428.74 / $2,628.75	Facility		$918.64	$1,428.74	$2,628.75
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $918.64 / $1,428.74 / $2,522.36	Professional		$918.64	$1,428.74	$2,522.36
Molina Facility/Professional Professional Modifier Low / Median / High Price $78.85 / $465.93 / $1,605.76	Professional		$78.85	$465.93	$1,605.76
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,042.64 / $1,471.32 / $1,662.94	Facility		$1,042.64	$1,471.32	$1,662.94
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,110.30 / $1,110.30 / $1,134.27	Facility		$1,110.30	$1,110.30	$1,134.27
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,167.53 / $1,877.48 / $2,251.42	Professional		$1,167.53	$1,877.48	$2,251.42
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $4,818.83 / $6,600.21 / $12,632.68	Facility		$4,818.83	$6,600.21	$12,632.68
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $1,132.35 / $1,631.66 / $2,120.11	Professional		$1,132.35	$1,631.66	$2,120.11
United Facility/Professional Facility Modifier Low / Median / High Price $1,224.00 / $1,862.00 / $10,522.00	Facility		$1,224.00	$1,862.00	$10,522.00
United Facility/Professional Professional Modifier Low / Median / High Price $893.01 / $1,214.47 / $2,226.52	Professional		$893.01	$1,214.47	$2,226.52