Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $843.18 / $1,429.01 / $4,942.47	Facility		$843.18	$1,429.01	$4,942.47
Aetna Facility/Professional Professional Modifier Low / Median / High Price $440.00 / $843.18 / $1,327.56	Professional		$440.00	$843.18	$1,327.56
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $941.85 / $1,471.98 / $4,260.75	Facility		$941.85	$1,471.98	$4,260.75
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $403.65 / $941.85 / $4,485.00	Professional		$403.65	$941.85	$4,485.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $932.88 / $1,836.61 / $2,332.19	Facility		$932.88	$1,836.61	$2,332.19
Cigna Facility/Professional Professional Modifier Low / Median / High Price $556.16 / $1,031.54 / $1,288.56	Professional		$556.16	$1,031.54	$1,288.56
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $885.36 / $1,133.55 / $2,774.72	Facility		$885.36	$1,133.55	$2,774.72
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $897.00 / $1,318.59 / $2,482.44	Professional		$897.00	$1,318.59	$2,482.44
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 $897.00 / $897.00 / $1,883.70	Facility		$897.00	$897.00	$1,883.70
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $897.00 / $1,345.50 / $2,466.75	Facility		$897.00	$1,345.50	$2,466.75
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $807.30 / $1,076.40 / $1,273.74	Professional		$807.30	$1,076.40	$1,273.74
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $941.85 / $1,471.98 / $2,466.75	Facility		$941.85	$1,471.98	$2,466.75
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $812.02 / $1,577.92 / $2,197.01	Professional		$812.02	$1,577.92	$2,197.01
United Facility/Professional Professional Modifier Low / Median / High Price $376.74 / $376.74 / $1,004.64	Professional		$376.74	$376.74	$1,004.64
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $403.65 / $403.65 / $464.65	Professional		$403.65	$403.65	$464.65