Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $704.20 / $1,212.91 / $1,703.54	Facility		$704.20	$1,212.91	$1,703.54
Aetna Facility/Professional Professional Modifier Low / Median / High Price $450.72 / $704.20 / $1,408.40	Professional		$450.72	$704.20	$1,408.40
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $1,085.85 / $1,732.47 / $5,991.20	Facility		$1,085.85	$1,732.47	$5,991.20
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $893.29 / $1,518.29 / $5,576.63	Professional		$893.29	$1,518.29	$5,576.63
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 $564.23 / $1,246.05 / $2,080.81	Professional		$564.23	$1,246.05	$2,080.81
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $540.95 / $952.05 / $2,130.92	Facility		$540.95	$952.05	$2,130.92
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $572.00 / $954.89 / $1,722.93	Professional		$572.00	$954.89	$1,722.93
Molina Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $584.33 / $1,443.65	Professional		$112.20	$584.33	$1,443.65
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $635.17 / $1,040.11 / $1,300.16	Facility		$635.17	$1,040.11	$1,300.16
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 $873.78 / $873.78 / $880.18	Facility		$873.78	$873.78	$880.18
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $966.90 / $1,459.41 / $1,746.72	Professional		$966.90	$1,459.41	$1,746.72
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 $897.67 / $1,309.72 / $1,737.43	Professional		$897.67	$1,309.72	$1,737.43
United Facility/Professional Facility Modifier Low / Median / High Price $493.70 / $515.09 / $528.76	Facility		$493.70	$515.09	$528.76
United Facility/Professional Professional Modifier Low / Median / High Price $454.54 / $780.89 / $1,710.66	Professional		$454.54	$780.89	$1,710.66
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $732.95 / $732.95 / $732.95	Professional		$732.95	$732.95	$732.95