Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $502.71 / $1,029.85 / $1,191.42	Facility		$502.71	$1,029.85	$1,191.42
Aetna Facility/Professional Professional Modifier Low / Median / High Price $193.00 / $502.71 / $1,141.15	Professional		$193.00	$502.71	$1,141.15
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $652.28 / $1,509.55 / $3,116.55	Facility		$652.28	$1,509.55	$3,116.55
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $459.82 / $633.17 / $4,135.50	Professional		$459.82	$633.17	$4,135.50
Cigna Facility/Professional Facility Modifier Low / Median / High Price $378.92 / $378.92 / $613.97	Facility		$378.92	$378.92	$613.97
Cigna Facility/Professional Professional Modifier Low / Median / High Price $276.61 / $276.61 / $613.97	Professional		$276.61	$276.61	$613.97
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $384.28 / $707.67 / $1,929.20	Facility		$384.28	$707.67	$1,929.20
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $385.92 / $707.67 / $1,234.63	Professional		$385.92	$707.67	$1,234.63
Molina Facility/Professional Professional Modifier Low / Median / High Price $513.96 / $571.07 / $628.17	Professional		$513.96	$571.07	$628.17
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $591.30 / $670.43 / $744.92	Facility		$591.30	$670.43	$744.92
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $629.30 / $744.92 / $744.92	Professional		$629.30	$744.92	$744.92
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $652.28 / $836.58 / $1,454.92	Facility		$652.28	$836.58	$1,454.92
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $709.03 / $727.46 / $727.46	Facility		$709.03	$727.46	$727.46
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $591.78 / $633.17 / $819.41	Professional		$591.78	$633.17	$819.41
United Facility/Professional Professional Modifier Low / Median / High Price $268.35 / $315.57 / $553.75	Professional		$268.35	$315.57	$553.75
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $212.33 / $212.33 / $352.59	Professional		$212.33	$212.33	$352.59