Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $461.04 / $663.48 / $1,048.23	Professional		$461.04	$663.48	$1,048.23
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $1,174.66 / $7,230.47 / $7,230.47	Facility		$1,174.66	$7,230.47	$7,230.47
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $782.48 / $1,037.47 / $1,357.03	Professional		$782.48	$1,037.47	$1,357.03
Cigna Facility/Professional Facility Modifier Low / Median / High Price $867.37 / $867.37 / $867.37	Facility		$867.37	$867.37	$867.37
Cigna Facility/Professional Professional Modifier Low / Median / High Price $737.26 / $867.37 / $890.46	Professional		$737.26	$867.37	$890.46
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,321.30 / $1,321.30 / $1,321.30	Facility		$1,321.30	$1,321.30	$1,321.30
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,321.30 / $1,321.30 / $1,321.30	Professional		$1,321.30	$1,321.30	$1,321.30
Molina Facility/Professional Professional Modifier Low / Median / High Price $129.90 / $864.17 / $1,188.24	Professional		$129.90	$864.17	$1,188.24
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,382.68 / $1,617.00 / $1,969.80	Facility		$1,382.68	$1,617.00	$1,969.80
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $1,617.00 / $1,969.80 / $1,969.80	Professional		$1,617.00	$1,969.80	$1,969.80
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $116.47 / $116.47 / $116.47	Facility		$116.47	$116.47	$116.47
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,090.47 / $1,187.99 / $1,332.87	Professional		$1,090.47	$1,187.99	$1,332.87
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $95.15 / $95.15 / $115.85	Professional		$95.15	$95.15	$115.85
United Facility/Professional Professional Modifier Low / Median / High Price $641.05 / $689.22 / $1,269.40	Professional		$641.05	$689.22	$1,269.40