Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,296.00 / $10,122.46 / $23,000.00	Facility		$1,296.00	$10,122.46	$23,000.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $954.68 / $1,174.64 / $1,451.14	Facility	54	$954.68	$1,174.64	$1,451.14
Aetna Facility/Professional Professional Modifier Low / Median / High Price $761.10 / $1,038.00 / $1,835.92	Professional		$761.10	$1,038.00	$1,835.92
Aetna Facility/Professional Professional Modifier 55 Low / Median / High Price $114.17 / $190.94 / $324.49	Professional	55	$114.17	$190.94	$324.49
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $1,121.18 / $14,482.75 / $28,332.57	Facility		$1,121.18	$14,482.75	$28,332.57
Asuris Northwest Health Facility/Professional Facility Modifier 54 Low / Median / High Price $8,513.79 / $14,161.14 / $14,161.14	Facility	54	$8,513.79	$14,161.14	$14,161.14
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $1,163.13 / $1,986.92 / $7,195.58	Professional		$1,163.13	$1,986.92	$7,195.58
Asuris Northwest Health Facility/Professional Professional Modifier 55 Low / Median / High Price $165.16 / $170.45 / $170.45	Professional	55	$165.16	$170.45	$170.45
Cigna Facility/Professional Facility Modifier Low / Median / High Price $734.00 / $734.00 / $8,912.83	Facility		$734.00	$734.00	$8,912.83
Cigna Facility/Professional Professional Modifier Low / Median / High Price $863.41 / $1,464.85 / $2,614.61	Professional		$863.41	$1,464.85	$2,614.61
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,085.92 / $2,098.25 / $7,816.26	Facility		$1,085.92	$2,098.25	$7,816.26
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,085.92 / $2,042.27 / $6,609.43	Professional		$1,085.92	$2,042.27	$6,609.43
Molina Facility/Professional Professional Modifier Low / Median / High Price $83.18 / $536.25 / $1,576.75	Professional		$83.18	$536.25	$1,576.75
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,114.51 / $1,664.91 / $1,699.79	Facility		$1,114.51	$1,664.91	$1,699.79
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,121.18 / $1,121.18 / $3,439.25	Facility		$1,121.18	$1,121.18	$3,439.25
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,193.40 / $1,909.86 / $2,301.31	Professional		$1,193.40	$1,909.86	$2,301.31
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $10,177.40 / $14,482.75 / $28,332.57	Facility		$10,177.40	$14,482.75	$28,332.57
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $1,143.45 / $1,661.87 / $2,604.23	Professional		$1,143.45	$1,661.87	$2,604.23
United Facility/Professional Facility Modifier Low / Median / High Price $2,263.00 / $2,912.00 / $16,315.00	Facility		$2,263.00	$2,912.00	$16,315.00
United Facility/Professional Professional Modifier Low / Median / High Price $1,039.50 / $1,336.51 / $2,423.41	Professional		$1,039.50	$1,336.51	$2,423.41