Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $634.60 / $754.60 / $1,426.69	Facility		$634.60	$754.60	$1,426.69
Aetna Facility/Professional Professional Modifier Low / Median / High Price $686.00 / $692.86 / $829.95	Professional		$686.00	$692.86	$829.95
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $609.16 / $913.76 / $3,209.15	Facility		$609.16	$913.76	$3,209.15
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $686.00 / $754.60 / $2,835.75	Professional		$686.00	$754.60	$2,835.75
Cigna Facility/Professional Facility Modifier Low / Median / High Price $642.29 / $647.16 / $1,283.66	Facility		$642.29	$647.16	$1,283.66
Cigna Facility/Professional Professional Modifier Low / Median / High Price $686.00 / $686.00 / $841.32	Professional		$686.00	$686.00	$841.32
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $686.00 / $686.00 / $1,909.59	Facility		$686.00	$686.00	$1,909.59
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $686.00 / $686.00 / $1,155.00	Professional		$686.00	$686.00	$1,155.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $30.00 / $30.00 / $30.00	Professional		$30.00	$30.00	$30.00
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $609.16 / $686.00 / $1,132.75	Facility		$609.16	$686.00	$1,132.75
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $538.88 / $932.94 / $1,707.34	Facility		$538.88	$932.94	$1,707.34
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $678.64 / $818.01 / $1,478.47	Professional		$678.64	$818.01	$1,478.47
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $609.16 / $754.60 / $1,305.96	Facility		$609.16	$754.60	$1,305.96
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $686.00 / $754.60 / $823.20	Professional		$686.00	$754.60	$823.20
United Facility/Professional Facility Modifier Low / Median / High Price $686.00 / $686.00 / $686.00	Facility		$686.00	$686.00	$686.00
United Facility/Professional Professional Modifier Low / Median / High Price $686.00 / $686.00 / $823.20	Professional		$686.00	$686.00	$823.20
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $642.29 / $686.00 / $686.00	Professional		$642.29	$686.00	$686.00