Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $713.51 / $1,259.66 / $4,182.37	Facility		$713.51	$1,259.66	$4,182.37
Aetna Facility/Professional Professional Modifier Low / Median / High Price $455.43 / $713.51 / $1,203.49	Professional		$455.43	$713.51	$1,203.49
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $797.00 / $1,431.64 / $3,605.49	Facility		$797.00	$1,431.64	$3,605.49
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $394.71 / $797.00 / $3,795.25	Professional		$394.71	$797.00	$3,795.25
Cigna Facility/Professional Facility Modifier Low / Median / High Price $373.18 / $1,110.10 / $1,959.95	Facility		$373.18	$1,110.10	$1,959.95
Cigna Facility/Professional Professional Modifier Low / Median / High Price $384.94 / $872.26 / $1,090.32	Professional		$384.94	$872.26	$1,090.32
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $748.96 / $958.95 / $2,347.71	Facility		$748.96	$958.95	$2,347.71
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $759.05 / $1,115.80 / $2,100.41	Professional		$759.05	$1,115.80	$2,100.41
Molina Facility/Professional Professional Modifier Low / Median / High Price $75.00 / $540.44 / $585.80	Professional		$75.00	$540.44	$585.80
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $759.05 / $759.05 / $1,594.01	Facility		$759.05	$759.05	$1,594.01
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $759.05 / $1,138.57 / $2,087.39	Facility		$759.05	$1,138.57	$2,087.39
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $683.15 / $910.86 / $1,077.84	Professional		$683.15	$910.86	$1,077.84
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $872.91 / $1,245.59 / $2,087.39	Facility		$872.91	$1,245.59	$2,087.39
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $687.28 / $1,334.94 / $1,859.20	Professional		$687.28	$1,334.94	$1,859.20
United Facility/Professional Professional Modifier Low / Median / High Price $318.80 / $318.80 / $850.14	Professional		$318.80	$318.80	$850.14
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $341.57 / $341.57 / $393.19	Professional		$341.57	$341.57	$393.19