Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $356.85 / $3,268.98 / $13,750.00	Facility		$356.85	$3,268.98	$13,750.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $169.62 / $1,042.51 / $3,261.23	Professional		$169.62	$1,042.51	$3,261.23
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $55.00 / $2,538.17 / $3,247.57	Facility		$55.00	$2,538.17	$3,247.57
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $315.56 / $3,367.39 / $13,644.24	Professional		$315.56	$3,367.39	$13,644.24
Cigna Facility/Professional Professional Modifier Low / Median / High Price $304.70 / $2,341.32 / $5,693.26	Professional		$304.70	$2,341.32	$5,693.26
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $290.26 / $1,730.11 / $4,987.25	Facility		$290.26	$1,730.11	$4,987.25
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $317.76 / $1,730.11 / $4,987.25	Professional		$317.76	$1,730.11	$4,987.25
Molina Facility/Professional Professional Modifier Low / Median / High Price $459.55 / $2,800.27 / $4,670.57	Professional		$459.55	$2,800.27	$4,670.57
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $350.44 / $3,499.23 / $3,820.93	Facility		$350.44	$3,499.23	$3,820.93
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,538.17 / $2,538.17 / $2,735.21	Facility		$2,538.17	$2,538.17	$2,735.21
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $336.20 / $650.46 / $4,652.59	Professional		$336.20	$650.46	$4,652.59
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $315.56 / $600.50 / $4,307.95	Professional		$315.56	$600.50	$4,307.95
United Facility/Professional Facility Modifier Low / Median / High Price $497.00 / $1,078.00 / $6,216.00	Facility		$497.00	$1,078.00	$6,216.00
United Facility/Professional Professional Modifier Low / Median / High Price $2,417.48 / $3,208.60 / $5,568.03	Professional		$2,417.48	$3,208.60	$5,568.03