Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $747.30 / $1,327.65 / $4,380.45	Facility		$747.30	$1,327.65	$4,380.45
Aetna Facility/Professional Professional Modifier Low / Median / High Price $747.30 / $759.00 / $825.00	Professional		$747.30	$759.00	$825.00
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $834.75 / $1,304.59 / $3,776.25	Facility		$834.75	$1,304.59	$3,776.25
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $500.00 / $795.00 / $3,975.00	Professional		$500.00	$795.00	$3,975.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $663.10 / $826.80 / $2,052.79	Facility		$663.10	$826.80	$2,052.79
Cigna Facility/Professional Professional Modifier Low / Median / High Price $493.01 / $913.56 / $1,141.95	Professional		$493.01	$913.56	$1,141.95
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $784.30 / $993.75 / $2,268.65	Facility		$784.30	$993.75	$2,268.65
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $795.00 / $1,168.65 / $2,200.46	Professional		$795.00	$1,168.65	$2,200.46
Molina Facility/Professional Professional Modifier Low / Median / High Price $566.04 / $766.94 / $843.63	Professional		$566.04	$766.94	$843.63
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $795.00 / $795.00 / $1,669.50	Facility		$795.00	$795.00	$1,669.50
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $795.00 / $1,192.50 / $2,186.25	Facility		$795.00	$1,192.50	$2,186.25
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $715.50 / $954.00 / $1,128.90	Professional		$715.50	$954.00	$1,128.90
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $834.75 / $1,304.59 / $2,186.25	Facility		$834.75	$1,304.59	$2,186.25
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $719.78 / $1,398.17 / $1,947.18	Professional		$719.78	$1,398.17	$1,947.18
United Facility/Professional Professional Modifier Low / Median / High Price $333.90 / $333.90 / $890.40	Professional		$333.90	$333.90	$890.40
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $357.75 / $357.75 / $411.81	Professional		$357.75	$357.75	$411.81