Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $562.55 / $562.55 / $562.55	Facility		$562.55	$562.55	$562.55
Aetna Facility/Professional Professional Modifier Low / Median / High Price $379.97 / $461.88 / $570.23	Professional		$379.97	$461.88	$570.23
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $659.91 / $976.88 / $2,184.44	Facility		$659.91	$976.88	$2,184.44
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $404.91 / $918.67 / $4,153.64	Professional		$404.91	$918.67	$4,153.64
Cigna Facility/Professional Professional Modifier Low / Median / High Price $518.75 / $988.23 / $1,554.68	Professional		$518.75	$988.23	$1,554.68
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $334.88 / $621.91 / $1,089.80	Facility		$334.88	$621.91	$1,089.80
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $374.22 / $586.75 / $1,063.52	Professional		$374.22	$586.75	$1,063.52
Molina Facility/Professional Professional Modifier Low / Median / High Price $45.00 / $50.00 / $604.07	Professional		$45.00	$50.00	$604.07
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $336.74 / $425.09 / $447.46	Facility		$336.74	$425.09	$447.46
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $598.41 / $598.41 / $659.91	Facility		$598.41	$598.41	$659.91
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $659.91 / $1,015.44 / $1,309.84	Professional		$659.91	$1,015.44	$1,309.84
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $649.04 / $888.99 / $1,701.50	Facility		$649.04	$888.99	$1,701.50
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $610.29 / $884.62 / $1,232.15	Professional		$610.29	$884.62	$1,232.15
United Facility/Professional Professional Modifier Low / Median / High Price $505.47 / $767.93 / $1,302.58	Professional		$505.47	$767.93	$1,302.58
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $447.46 / $517.14 / $595.55	Professional		$447.46	$517.14	$595.55