Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $879.84 / $1,563.12 / $5,157.35	Facility		$879.84	$1,563.12	$5,157.35
Aetna Facility/Professional Professional Modifier Low / Median / High Price $561.60 / $879.84 / $1,385.28	Professional		$561.60	$879.84	$1,385.28
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $982.80 / $1,535.98 / $4,446.00	Facility		$982.80	$1,535.98	$4,446.00
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $400.39 / $986.55 / $4,680.00	Professional		$400.39	$986.55	$4,680.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $973.44 / $1,916.46 / $2,433.60	Facility		$973.44	$1,916.46	$2,433.60
Cigna Facility/Professional Professional Modifier Low / Median / High Price $580.53 / $1,075.86 / $1,344.83	Professional		$580.53	$1,075.86	$1,344.83
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $923.80 / $1,170.00 / $2,672.16	Facility		$923.80	$1,170.00	$2,672.16
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $936.00 / $1,375.92 / $2,590.08	Professional		$936.00	$1,375.92	$2,590.08
Molina Facility/Professional Professional Modifier Low / Median / High Price $666.43 / $902.96 / $993.25	Professional		$666.43	$902.96	$993.25
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $936.00 / $936.00 / $1,965.60	Facility		$936.00	$936.00	$1,965.60
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $936.00 / $1,404.00 / $2,574.00	Facility		$936.00	$1,404.00	$2,574.00
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $842.40 / $1,123.20 / $1,329.12	Professional		$842.40	$1,123.20	$1,329.12
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $982.80 / $1,535.98 / $2,574.00	Facility		$982.80	$1,535.98	$2,574.00
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $847.45 / $1,646.43 / $2,292.46	Professional		$847.45	$1,646.43	$2,292.46
United Facility/Professional Professional Modifier Low / Median / High Price $393.12 / $393.12 / $1,048.32	Professional		$393.12	$393.12	$1,048.32
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $421.20 / $421.20 / $484.85	Professional		$421.20	$421.20	$484.85