Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $580.02 / $852.06 / $2,848.67	Facility		$580.02	$852.06	$2,848.67
Aetna Facility/Professional Professional Modifier Low / Median / High Price $652.72 / $741.00 / $1,007.54	Professional		$652.72	$741.00	$1,007.54
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $613.57 / $989.30 / $3,525.70	Facility		$613.57	$989.30	$3,525.70
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $733.67 / $807.04 / $3,104.06	Professional		$733.67	$807.04	$3,104.06
Cigna Facility/Professional Facility Modifier Low / Median / High Price $692.14 / $703.06 / $1,704.92	Facility		$692.14	$703.06	$1,704.92
Cigna Facility/Professional Professional Modifier Low / Median / High Price $733.67 / $733.67 / $899.78	Professional		$733.67	$733.67	$899.78
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $437.40 / $733.67 / $1,584.97	Facility		$437.40	$733.67	$1,584.97
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $443.30 / $733.67 / $1,452.65	Professional		$443.30	$733.67	$1,452.65
Molina Facility/Professional Professional Modifier Low / Median / High Price $30.00 / $75.00 / $734.15	Professional		$30.00	$75.00	$734.15
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $733.67 / $831.11 / $2,201.01	Facility		$733.67	$831.11	$2,201.01
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $543.16 / $1,004.86 / $1,705.23	Facility		$543.16	$1,004.86	$1,705.23
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $782.65 / $895.40 / $1,618.35	Professional		$782.65	$895.40	$1,618.35
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $659.53 / $797.64 / $1,319.06	Facility		$659.53	$797.64	$1,319.06
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $733.67 / $807.04 / $880.40	Professional		$733.67	$807.04	$880.40
United Facility/Professional Professional Modifier Low / Median / High Price $733.67 / $733.67 / $880.40	Professional		$733.67	$733.67	$880.40
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $703.06 / $733.67 / $733.67	Professional		$703.06	$733.67	$733.67