Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,063.08 / $1,063.40 / $1,676.07	Professional		$1,063.08	$1,063.40	$1,676.07
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $1,772.79 / $11,227.13 / $11,227.13	Facility		$1,772.79	$11,227.13	$11,227.13
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $1,180.80 / $1,565.74 / $2,233.14	Professional		$1,180.80	$1,565.74	$2,233.14
Cigna Facility/Professional Professional Modifier Low / Median / High Price $169.88 / $1,743.98 / $2,463.75	Professional		$169.88	$1,743.98	$2,463.75
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $2,126.80 / $2,126.80 / $2,126.80	Facility		$2,126.80	$2,126.80	$2,126.80
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $2,126.80 / $2,126.80 / $2,126.80	Professional		$2,126.80	$2,126.80	$2,126.80
Molina Facility/Professional Professional Modifier Low / Median / High Price $196.03 / $1,304.36 / $1,793.50	Professional		$196.03	$1,304.36	$1,793.50
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $2,086.75 / $3,858.83 / $4,249.81	Facility		$2,086.75	$3,858.83	$4,249.81
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $3,488.65 / $4,190.31 / $4,249.81	Professional		$3,488.65	$4,190.31	$4,249.81
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $186.23 / $186.23 / $186.23	Facility		$186.23	$186.23	$186.23
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $374.51 / $1,765.45 / $2,388.55	Professional		$374.51	$1,765.45	$2,388.55
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $143.62 / $143.62 / $174.87	Professional		$143.62	$143.62	$174.87
United Facility/Professional Professional Modifier Low / Median / High Price $967.49 / $1,057.80 / $2,024.40	Professional		$967.49	$1,057.80	$2,024.40
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,516.04 / $1,516.04 / $1,516.04	Professional		$1,516.04	$1,516.04	$1,516.04