Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $477.60 / $477.60 / $477.60	Professional		$477.60	$477.60	$477.60
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $716.40 / $1,091.66 / $2,818.81	Facility		$716.40	$1,091.66	$2,818.81
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $614.05 / $1,417.57 / $5,117.18	Professional		$614.05	$1,417.57	$5,117.18
Cigna Facility/Professional Facility Modifier Low / Median / High Price $709.58 / $1,450.35 / $1,761.76	Facility		$709.58	$1,450.35	$1,761.76
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $614.05 / $682.29 / $1,705.72	Facility		$614.05	$682.29	$1,705.72
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $614.05 / $682.29 / $1,705.72	Professional		$614.05	$682.29	$1,705.72
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 $614.05 / $750.52 / $1,194.01	Facility		$614.05	$750.52	$1,194.01
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $682.29 / $1,194.01 / $2,046.87	Facility		$682.29	$1,194.01	$2,046.87
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $614.05 / $852.86 / $1,030.26	Professional		$614.05	$852.86	$1,030.26
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $716.40 / $1,119.64 / $1,876.30	Facility		$716.40	$1,119.64	$1,876.30
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $754.61 / $1,328.05 / $1,586.70	Professional		$754.61	$1,328.05	$1,586.70
United Facility/Professional Professional Modifier Low / Median / High Price $286.56 / $286.56 / $764.16	Professional		$286.56	$286.56	$764.16