Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $450.21 / $1,021.98 / $1,067.00	Facility		$450.21	$1,021.98	$1,067.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $324.50 / $450.21 / $1,067.00	Professional		$324.50	$450.21	$1,067.00
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $584.16 / $1,301.43 / $2,961.69	Facility		$584.16	$1,301.43	$2,961.69
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $438.29 / $579.36 / $3,571.63	Professional		$438.29	$579.36	$3,571.63
Cigna Facility/Professional Facility Modifier Low / Median / High Price $419.04 / $419.04 / $419.04	Facility		$419.04	$419.04	$419.04
Cigna Facility/Professional Professional Modifier Low / Median / High Price $305.89 / $305.89 / $588.92	Professional		$305.89	$305.89	$588.92
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $368.16 / $667.13 / $1,727.72	Facility		$368.16	$667.13	$1,727.72
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $370.56 / $667.13 / $1,184.15	Professional		$370.56	$667.13	$1,184.15
Molina Facility/Professional Professional Modifier Low / Median / High Price $460.27 / $511.42 / $562.56	Professional		$460.27	$511.42	$562.56
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $529.54 / $600.41 / $667.13	Facility		$529.54	$600.41	$667.13
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $579.46 / $667.13 / $667.13	Professional		$579.46	$667.13	$667.13
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $584.16 / $749.21 / $1,302.98	Facility		$584.16	$749.21	$1,302.98
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $634.98 / $651.49 / $651.49	Facility		$634.98	$651.49	$651.49
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $529.97 / $567.05 / $733.84	Professional		$529.97	$567.05	$733.84
United Facility/Professional Professional Modifier Low / Median / High Price $257.41 / $278.86 / $531.16	Professional		$257.41	$278.86	$531.16
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $301.83 / $301.83 / $339.37	Professional		$301.83	$301.83	$339.37