Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $756.30 / $759.96 / $1,200.59	Professional		$756.30	$759.96	$1,200.59
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $133.40 / $8,276.54 / $8,276.54	Facility		$133.40	$8,276.54	$8,276.54
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $800.00 / $1,189.97 / $1,688.89	Professional		$800.00	$1,189.97	$1,688.89
Cigna Facility/Professional Facility Modifier Low / Median / High Price $642.26 / $642.26 / $642.26	Facility		$642.26	$642.26	$642.26
Cigna Facility/Professional Professional Modifier Low / Median / High Price $545.91 / $642.26 / $859.03	Professional		$545.91	$642.26	$859.03
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,512.60 / $1,512.60 / $1,512.60	Facility		$1,512.60	$1,512.60	$1,512.60
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,512.60 / $1,512.60 / $1,512.60	Professional		$1,512.60	$1,512.60	$1,512.60
Molina Facility/Professional Professional Modifier Low / Median / High Price $148.97 / $991.32 / $1,363.07	Professional		$148.97	$991.32	$1,363.07
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,585.94 / $1,851.30 / $2,255.21	Facility		$1,585.94	$1,851.30	$2,255.21
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $1,851.30 / $2,255.21 / $2,255.21	Professional		$1,851.30	$2,255.21	$2,255.21
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $133.40 / $133.40 / $133.40	Facility		$133.40	$133.40	$133.40
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $142.44 / $1,248.31 / $2,689.90	Professional		$142.44	$1,248.31	$2,689.90
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $109.15 / $109.15 / $132.90	Professional		$109.15	$109.15	$132.90
United Facility/Professional Professional Modifier Low / Median / High Price $735.30 / $756.24 / $1,454.00	Professional		$735.30	$756.24	$1,454.00