Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $464.40 / $1,140.44 / $17,930.00	Facility		$464.40	$1,140.44	$17,930.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $227.21 / $384.34 / $749.61	Professional		$227.21	$384.34	$749.61
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $515.21 / $515.21 / $721.29	Professional	50	$515.21	$515.21	$721.29
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $144.77 / $825.07 / $1,775.28	Facility		$144.77	$825.07	$1,775.28
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $444.37 / $837.26 / $3,716.03	Professional		$444.37	$837.26	$3,716.03
Asuris Northwest Health Facility/Professional Professional Modifier 50 Low / Median / High Price $255.83 / $1,230.05 / $1,909.50	Professional	50	$255.83	$1,230.05	$1,909.50
Cigna Facility/Professional Facility Modifier Low / Median / High Price $379.24 / $379.24 / $379.24	Facility		$379.24	$379.24	$379.24
Cigna Facility/Professional Professional Modifier Low / Median / High Price $305.44 / $557.24 / $1,154.22	Professional		$305.44	$557.24	$1,154.22
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $193.47 / $516.36 / $1,021.02	Facility		$193.47	$516.36	$1,021.02
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $194.69 / $528.41 / $1,050.23	Professional		$194.69	$528.41	$1,050.23
Molina Facility/Professional Professional Modifier Low / Median / High Price $45.89 / $452.17 / $959.82	Professional		$45.89	$452.17	$959.82
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $490.44 / $789.17 / $868.32	Facility		$490.44	$789.17	$868.32
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $144.77 / $583.91 / $592.27	Facility		$144.77	$583.91	$592.27
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $412.51 / $646.49 / $1,086.05	Professional		$412.51	$646.49	$1,086.05
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $602.39 / $825.55 / $1,579.18	Facility		$602.39	$825.55	$1,579.18
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $337.72 / $595.52 / $1,068.94	Professional		$337.72	$595.52	$1,068.94
United Facility/Professional Facility Modifier Low / Median / High Price $118.00 / $414.00 / $5,793.00	Facility		$118.00	$414.00	$5,793.00
United Facility/Professional Professional Modifier Low / Median / High Price $355.58 / $588.71 / $1,169.41	Professional		$355.58	$588.71	$1,169.41