Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $416.78 / $937.50 / $1,979.71	Facility		$416.78	$937.50	$1,979.71
Aetna Facility/Professional Professional Modifier Low / Median / High Price $216.73 / $416.78 / $572.36	Professional		$216.73	$416.78	$572.36
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $416.78 / $654.34 / $1,721.88	Facility		$416.78	$654.34	$1,721.88
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $375.10 / $814.38 / $3,125.85	Professional		$375.10	$814.38	$3,125.85
Cigna Facility/Professional Facility Modifier Low / Median / High Price $283.41 / $677.28 / $1,076.19	Facility		$283.41	$677.28	$1,076.19
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $375.10 / $416.78 / $2,100.15	Facility		$375.10	$416.78	$2,100.15
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $375.10 / $416.78 / $1,041.95	Professional		$375.10	$416.78	$1,041.95
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 $416.78 / $416.78 / $583.49	Facility		$416.78	$416.78	$583.49
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $416.78 / $729.37 / $1,250.33	Facility		$416.78	$729.37	$1,250.33
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $375.10 / $520.97 / $629.34	Professional		$375.10	$520.97	$629.34
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $437.62 / $666.85 / $1,146.15	Facility		$437.62	$666.85	$1,146.15
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $460.96 / $810.84 / $969.05	Professional		$460.96	$810.84	$969.05
United Facility/Professional Professional Modifier Low / Median / High Price $175.05 / $175.07 / $466.79	Professional		$175.05	$175.07	$466.79