Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $425.60 / $829.84 / $1,408.65	Facility		$425.60	$829.84	$1,408.65
Aetna Facility/Professional Professional Modifier Low / Median / High Price $348.65 / $435.87 / $941.64	Professional		$348.65	$435.87	$941.64
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $1,085.85 / $1,732.47 / $5,563.56	Facility		$1,085.85	$1,732.47	$5,563.56
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $559.94 / $983.84 / $3,613.43	Professional		$559.94	$983.84	$3,613.43
Cigna Facility/Professional Facility Modifier Low / Median / High Price $506.43 / $1,511.72 / $2,276.14	Facility		$506.43	$1,511.72	$2,276.14
Cigna Facility/Professional Professional Modifier Low / Median / High Price $504.29 / $826.27 / $1,347.67	Professional		$504.29	$826.27	$1,347.67
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $384.09 / $758.72 / $1,557.63	Facility		$384.09	$758.72	$1,557.63
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $396.44 / $785.95 / $1,111.01	Professional		$396.44	$785.95	$1,111.01
Molina Facility/Professional Professional Modifier Low / Median / High Price $68.44 / $399.77 / $896.35	Professional		$68.44	$399.77	$896.35
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $537.79 / $743.70 / $847.55	Facility		$537.79	$743.70	$847.55
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $269.02 / $269.02 / $346.73	Professional		$269.02	$269.02	$346.73
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $549.04 / $549.04 / $578.11	Facility		$549.04	$549.04	$578.11
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $641.61 / $964.31 / $1,147.48	Professional		$641.61	$964.31	$1,147.48
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 $559.94 / $862.94 / $1,136.22	Professional		$559.94	$862.94	$1,136.22
United Facility/Professional Professional Modifier Low / Median / High Price $439.11 / $529.05 / $1,081.88	Professional		$439.11	$529.05	$1,081.88
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $480.74 / $480.74 / $480.74	Professional		$480.74	$480.74	$480.74