Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $731.78 / $1,297.38 / $2,045.34	Professional		$731.78	$1,297.38	$2,045.34
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $227.26 / $11,644.83 / $11,644.83	Facility		$227.26	$11,644.83	$11,644.83
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $1,441.59 / $1,910.52 / $2,725.07	Professional		$1,441.59	$1,910.52	$2,725.07
Cigna Facility/Professional Facility Modifier Low / Median / High Price $192.60 / $1,436.52 / $1,436.52	Facility		$192.60	$1,436.52	$1,436.52
Cigna Facility/Professional Professional Modifier Low / Median / High Price $192.60 / $1,221.04 / $3,007.50	Professional		$192.60	$1,221.04	$3,007.50
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $2,595.30 / $2,595.30 / $2,595.30	Facility		$2,595.30	$2,595.30	$2,595.30
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $2,595.30 / $2,595.30 / $2,595.30	Professional		$2,595.30	$2,595.30	$2,595.30
Molina Facility/Professional Professional Modifier Low / Median / High Price $228.10 / $278.79 / $2,787.95	Professional		$228.10	$278.79	$2,787.95
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $2,194.63 / $4,002.40 / $4,407.93	Facility		$2,194.63	$4,002.40	$4,407.93
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $3,618.45 / $4,346.22 / $4,407.93	Professional		$3,618.45	$4,346.22	$4,407.93
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $227.26 / $227.26 / $227.26	Facility		$227.26	$227.26	$227.26
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $457.01 / $2,154.33 / $4,570.06	Professional		$457.01	$2,154.33	$4,570.06
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $175.25 / $175.25 / $213.38	Professional		$175.25	$175.25	$213.38
United Facility/Professional Professional Modifier Low / Median / High Price $1,017.50 / $1,092.43 / $1,820.72	Professional		$1,017.50	$1,092.43	$1,820.72
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,594.41 / $1,594.41 / $1,594.41	Professional		$1,594.41	$1,594.41	$1,594.41