Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $645.61 / $1,144.56 / $1,804.41	Professional		$645.61	$1,144.56	$1,804.41
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $200.49 / $10,273.09 / $10,273.09	Facility		$200.49	$10,273.09	$10,273.09
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $1,271.24 / $1,685.57 / $2,404.19	Professional		$1,271.24	$1,685.57	$2,404.19
Cigna Facility/Professional Facility Modifier Low / Median / High Price $173.31 / $1,082.51 / $1,082.51	Facility		$173.31	$1,082.51	$1,082.51
Cigna Facility/Professional Professional Modifier Low / Median / High Price $169.91 / $920.13 / $1,566.00	Professional		$169.91	$920.13	$1,566.00
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $2,289.69 / $2,289.69 / $2,289.69	Facility		$2,289.69	$2,289.69	$2,289.69
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $2,289.69 / $2,289.69 / $2,289.69	Professional		$2,289.69	$2,289.69	$2,289.69
Molina Facility/Professional Professional Modifier Low / Median / High Price $201.24 / $245.96 / $2,459.60	Professional		$201.24	$245.96	$2,459.60
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,936.23 / $3,530.92 / $3,888.68	Facility		$1,936.23	$3,530.92	$3,888.68
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $3,192.20 / $3,834.24 / $3,888.68	Professional		$3,192.20	$3,834.24	$3,888.68
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $200.49 / $200.49 / $200.49	Facility		$200.49	$200.49	$200.49
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,900.60 / $2,045.00 / $2,571.40	Professional		$1,900.60	$2,045.00	$2,571.40
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $154.61 / $154.61 / $188.25	Professional		$154.61	$154.61	$188.25
United Facility/Professional Professional Modifier Low / Median / High Price $897.70 / $963.59 / $1,605.99	Professional		$897.70	$963.59	$1,605.99
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,406.68 / $1,406.68 / $1,406.68	Professional		$1,406.68	$1,406.68	$1,406.68