Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $772.86 / $1,572.22 / $3,213.79	Facility		$772.86	$1,572.22	$3,213.79
Aetna Facility/Professional Professional Modifier Low / Median / High Price $608.82 / $772.86 / $1,572.22	Professional		$608.82	$772.86	$1,572.22
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $1,085.85 / $1,668.20 / $3,191.07	Facility		$1,085.85	$1,668.20	$3,191.07
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $954.49 / $1,638.96 / $5,962.05	Professional		$954.49	$1,638.96	$5,962.05
Cigna Facility/Professional Facility Modifier Low / Median / High Price $735.60 / $1,511.72 / $2,276.14	Facility		$735.60	$1,511.72	$2,276.14
Cigna Facility/Professional Professional Modifier Low / Median / High Price $915.65 / $1,476.62 / $2,276.80	Professional		$915.65	$1,476.62	$2,276.80
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $554.12 / $1,447.81 / $2,313.75	Facility		$554.12	$1,447.81	$2,313.75
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $841.09 / $1,526.11 / $2,223.81	Professional		$841.09	$1,526.11	$2,223.81
Molina Facility/Professional Professional Modifier Low / Median / High Price $78.85 / $610.05 / $1,578.01	Professional		$78.85	$610.05	$1,578.01
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,111.42 / $1,333.81 / $1,865.95	Facility		$1,111.42	$1,333.81	$1,865.95
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $401.69 / $401.69 / $401.69	Professional		$401.69	$401.69	$401.69
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $935.90 / $935.90 / $938.68	Facility		$935.90	$935.90	$938.68
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,065.02 / $1,572.02 / $1,925.21	Professional		$1,065.02	$1,572.02	$1,925.21
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $1,081.75 / $1,627.87 / $3,172.39	Facility		$1,081.75	$1,627.87	$3,172.39
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $954.49 / $1,421.37 / $1,927.47	Professional		$954.49	$1,421.37	$1,927.47
United Facility/Professional Professional Modifier Low / Median / High Price $657.93 / $875.14 / $1,789.57	Professional		$657.93	$875.14	$1,789.57
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $788.74 / $788.74 / $788.74	Professional		$788.74	$788.74	$788.74