Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $837.90 / $848.10 / $1,323.72	Professional		$837.90	$848.10	$1,323.72
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $147.08 / $8,901.35 / $8,901.35	Facility		$147.08	$8,901.35	$8,901.35
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $189.38 / $1,250.33 / $2,603.94	Professional		$189.38	$1,250.33	$2,603.94
Cigna Facility/Professional Facility Modifier Low / Median / High Price $799.37 / $799.37 / $799.37	Facility		$799.37	$799.37	$799.37
Cigna Facility/Professional Professional Modifier Low / Median / High Price $145.52 / $679.46 / $1,016.17	Professional		$145.52	$679.46	$1,016.17
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,696.20 / $1,696.20 / $1,696.20	Facility		$1,696.20	$1,696.20	$1,696.20
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,696.20 / $1,696.20 / $1,696.20	Professional		$1,696.20	$1,696.20	$1,696.20
Molina Facility/Professional Professional Modifier Low / Median / High Price $1,171.69 / $1,301.88 / $1,432.06	Professional		$1,171.69	$1,301.88	$1,432.06
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,666.40 / $3,059.44 / $3,369.43	Facility		$1,666.40	$3,059.44	$3,369.43
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $2,765.95 / $3,322.26 / $3,369.43	Professional		$2,765.95	$3,322.26	$3,369.43
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $147.08 / $147.08 / $147.08	Facility		$147.08	$147.08	$147.08
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $189.38 / $1,523.04 / $2,965.92	Professional		$189.38	$1,523.04	$2,965.92
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $114.67 / $114.67 / $139.62	Professional		$114.67	$114.67	$139.62
United Facility/Professional Professional Modifier Low / Median / High Price $833.76 / $1,294.24 / $1,603.20	Professional		$833.76	$1,294.24	$1,603.20
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,210.64 / $1,210.64 / $1,210.64	Professional		$1,210.64	$1,210.64	$1,210.64