Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $500.64 / $500.75 / $1,113.73	Professional		$500.64	$500.75	$1,113.73
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $4,704.66 / $4,704.66	Facility		$100.00	$4,704.66	$4,704.66
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $83.12 / $737.27 / $1,051.56	Professional		$83.12	$737.27	$1,051.56
Cigna Facility/Professional Facility Modifier Low / Median / High Price $615.17 / $615.17 / $615.17	Facility		$615.17	$615.17	$615.17
Cigna Facility/Professional Professional Modifier Low / Median / High Price $522.90 / $615.17 / $743.21	Professional		$522.90	$615.17	$743.21
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,001.49 / $1,001.49 / $1,001.49	Facility		$1,001.49	$1,001.49	$1,001.49
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,001.49 / $1,001.49 / $1,001.49	Professional		$1,001.49	$1,001.49	$1,001.49
Molina Facility/Professional Professional Modifier Low / Median / High Price $690.96 / $767.74 / $844.51	Professional		$690.96	$767.74	$844.51
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $901.34 / $978.02 / $1,101.64	Facility		$901.34	$978.02	$1,101.64
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $901.34 / $1,001.49 / $1,001.49	Professional		$901.34	$1,001.49	$1,001.49
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $87.68 / $876.95 / $876.95	Facility		$87.68	$876.95	$876.95
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $83.12 / $831.32 / $1,124.72	Professional		$83.12	$831.32	$1,124.72
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $978.02 / $978.02 / $978.02	Facility		$978.02	$978.02	$978.02
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $67.62 / $67.62 / $82.33	Professional		$67.62	$67.62	$82.33
United Facility/Professional Professional Modifier Low / Median / High Price $392.65 / $424.69 / $810.25	Professional		$392.65	$424.69	$810.25