Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $800.70 / $810.60 / $1,265.04	Professional		$800.70	$810.60	$1,265.04
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $140.56 / $8,508.41 / $8,508.41	Facility		$140.56	$8,508.41	$8,508.41
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $900.46 / $1,194.02 / $1,809.99	Professional		$900.46	$1,194.02	$1,809.99
Cigna Facility/Professional Facility Modifier Low / Median / High Price $902.06 / $902.06 / $902.06	Facility		$902.06	$902.06	$902.06
Cigna Facility/Professional Professional Modifier Low / Median / High Price $139.08 / $766.75 / $989.98	Professional		$139.08	$766.75	$989.98
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,621.20 / $1,621.20 / $1,621.20	Facility		$1,621.20	$1,621.20	$1,621.20
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,621.20 / $1,621.20 / $1,621.20	Professional		$1,621.20	$1,621.20	$1,621.20
Molina Facility/Professional Professional Modifier Low / Median / High Price $149.52 / $994.80 / $1,367.85	Professional		$149.52	$994.80	$1,367.85
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,591.34 / $2,924.39 / $3,220.69	Facility		$1,591.34	$2,924.39	$3,220.69
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $2,643.85 / $3,175.60 / $3,220.69	Professional		$2,643.85	$3,175.60	$3,220.69
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $140.56 / $140.56 / $140.56	Facility		$140.56	$140.56	$140.56
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,337.82 / $1,526.68 / $2,834.20	Professional		$1,337.82	$1,526.68	$2,834.20
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $109.53 / $109.53 / $133.36	Professional		$109.53	$109.53	$133.36
United Facility/Professional Facility Modifier Low / Median / High Price $9.33 / $547.76 / $1,054.72	Facility		$9.33	$547.76	$1,054.72
United Facility/Professional Professional Modifier Low / Median / High Price $737.80 / $796.74 / $1,532.00	Professional		$737.80	$796.74	$1,532.00
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,156.10 / $1,156.10 / $1,156.10	Professional		$1,156.10	$1,156.10	$1,156.10