Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $495.24 / $675.05 / $1,247.90	Professional		$495.24	$675.05	$1,247.90
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $4,806.31 / $4,806.31	Facility		$100.00	$4,806.31	$4,806.31
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $700.28 / $818.99 / $1,292.77	Professional		$700.28	$818.99	$1,292.77
Cigna Facility/Professional Facility Modifier Low / Median / High Price $670.25 / $670.25 / $897.30	Facility		$670.25	$670.25	$897.30
Cigna Facility/Professional Professional Modifier Low / Median / High Price $569.71 / $670.25 / $918.00	Professional		$569.71	$670.25	$918.00
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $989.73 / $989.73 / $989.73	Facility		$989.73	$989.73	$989.73
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $989.73 / $989.73 / $989.73	Professional		$989.73	$989.73	$989.73
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $989.73 / $990.47 / $1,328.82	Facility		$989.73	$990.47	$1,328.82
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $989.73 / $990.47 / $1,328.82	Professional		$989.73	$990.47	$1,328.82
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $98.22 / $982.12 / $982.12	Facility		$98.22	$982.12	$982.12
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $81.68 / $960.90 / $1,292.77	Professional		$81.68	$960.90	$1,292.77
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $960.90 / $960.90 / $960.90	Facility		$960.90	$960.90	$960.90
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $105.14 / $105.14 / $128.02	Professional		$105.14	$105.14	$128.02
United Facility/Professional Professional Modifier Low / Median / High Price $551.47 / $610.39 / $1,059.32	Professional		$551.47	$610.39	$1,059.32
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,027.29 / $1,027.29 / $1,027.29	Professional		$1,027.29	$1,027.29	$1,027.29