Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $318.75 / $525.92 / $1,214.63	Facility		$318.75	$525.92	$1,214.63
Aetna Facility/Professional Professional Modifier Low / Median / High Price $318.75 / $318.75 / $603.00	Professional		$318.75	$318.75	$603.00
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $832.47 / $1,131.83 / $2,202.11	Facility		$832.47	$1,131.83	$2,202.11
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $89.22 / $428.72 / $1,181.00	Professional		$89.22	$428.72	$1,181.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $456.53 / $1,019.25 / $1,796.10	Facility		$456.53	$1,019.25	$1,796.10
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,761.84 / $1,761.84 / $1,761.84	Professional		$1,761.84	$1,761.84	$1,761.84
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $376.09 / $1,002.46 / $2,149.23	Facility		$376.09	$1,002.46	$2,149.23
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $366.42 / $931.00 / $79,999.20	Facility		$366.42	$931.00	$79,999.20
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $414.81 / $414.81 / $414.81	Facility		$414.81	$414.81	$414.81
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $832.47 / $1,131.83 / $2,084.75	Facility		$832.47	$1,131.83	$2,084.75
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $190.54 / $190.54 / $428.72	Professional		$190.54	$190.54	$428.72