Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $528.75 / $1,691.25 / $2,677.50	Facility		$528.75	$1,691.25	$2,677.50
Aetna Facility/Professional Professional Modifier Low / Median / High Price $198.75 / $262.50 / $262.50	Professional		$198.75	$262.50	$262.50
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $393.75 / $600.00 / $1,549.28	Facility		$393.75	$600.00	$1,549.28
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $370.72 / $779.48 / $2,812.50	Professional		$370.72	$779.48	$2,812.50
Cigna Facility/Professional Facility Modifier Low / Median / High Price $390.00 / $797.14 / $968.30	Facility		$390.00	$797.14	$968.30
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $337.50 / $375.00 / $937.50	Facility		$337.50	$375.00	$937.50
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $337.50 / $375.00 / $937.50	Professional		$337.50	$375.00	$937.50
Molina Facility/Professional Professional Modifier Low / Median / High Price $75.00 / $75.00 / $75.00	Professional		$75.00	$75.00	$75.00
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $337.50 / $412.50 / $656.25	Facility		$337.50	$412.50	$656.25
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $375.00 / $656.25 / $1,125.00	Facility		$375.00	$656.25	$1,125.00
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $337.50 / $468.75 / $566.25	Professional		$337.50	$468.75	$566.25
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $393.75 / $600.00 / $1,031.25	Facility		$393.75	$600.00	$1,031.25
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $414.75 / $730.03 / $872.30	Professional		$414.75	$730.03	$872.30
United Facility/Professional Professional Modifier Low / Median / High Price $157.50 / $157.50 / $420.00	Professional		$157.50	$157.50	$420.00