Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $987.00 / $1,672.76 / $5,785.50	Facility		$987.00	$1,672.76	$5,785.50
Aetna Facility/Professional Professional Modifier Low / Median / High Price $729.65 / $987.00 / $1,672.76	Professional		$729.65	$987.00	$1,672.76
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $1,102.50 / $1,723.05 / $4,987.50	Facility		$1,102.50	$1,723.05	$4,987.50
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $472.58 / $1,071.00 / $5,250.00	Professional		$472.58	$1,071.00	$5,250.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,092.00 / $2,149.88 / $2,730.00	Facility		$1,092.00	$2,149.88	$2,730.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $555.12 / $1,206.36 / $1,507.97	Professional		$555.12	$1,206.36	$1,507.97
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,036.33 / $1,327.05 / $3,247.50	Facility		$1,036.33	$1,327.05	$3,247.50
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,050.00 / $1,543.50 / $2,905.41	Professional		$1,050.00	$1,543.50	$2,905.41
Molina Facility/Professional Professional Modifier Low / Median / High Price $75.00 / $75.00 / $75.00	Professional		$75.00	$75.00	$75.00
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,050.00 / $1,050.00 / $2,205.00	Facility		$1,050.00	$1,050.00	$2,205.00
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,050.00 / $1,575.00 / $2,887.50	Facility		$1,050.00	$1,575.00	$2,887.50
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $945.00 / $1,260.00 / $1,491.00	Professional		$945.00	$1,260.00	$1,491.00
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $1,102.50 / $1,723.05 / $2,887.50	Facility		$1,102.50	$1,723.05	$2,887.50
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $950.53 / $1,846.67 / $2,572.17	Professional		$950.53	$1,846.67	$2,572.17
United Facility/Professional Professional Modifier Low / Median / High Price $437.79 / $441.00 / $1,176.00	Professional		$437.79	$441.00	$1,176.00
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $472.50 / $472.50 / $543.90	Professional		$472.50	$472.50	$543.90