Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $796.64 / $1,504.20 / $1,888.04	Facility		$796.64	$1,504.20	$1,888.04
Aetna Facility/Professional Professional Modifier Low / Median / High Price $684.75 / $796.64 / $1,888.04	Professional		$684.75	$796.64	$1,888.04
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $1,033.66 / $2,455.26 / $5,632.19	Facility		$1,033.66	$2,455.26	$5,632.19
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $840.65 / $1,033.06 / $6,089.34	Professional		$840.65	$1,033.06	$6,089.34
Cigna Facility/Professional Facility Modifier Low / Median / High Price $944.53 / $944.53 / $944.53	Facility		$944.53	$944.53	$944.53
Cigna Facility/Professional Professional Modifier Low / Median / High Price $689.51 / $689.51 / $944.53	Professional		$689.51	$689.51	$944.53
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $713.44 / $1,194.75 / $3,093.75	Facility		$713.44	$1,194.75	$3,093.75
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $717.12 / $1,204.08 / $2,293.00	Professional		$717.12	$1,204.08	$2,293.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $814.45 / $904.95 / $995.44	Professional		$814.45	$904.95	$995.44
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $937.01 / $1,152.80 / $1,222.76	Facility		$937.01	$1,152.80	$1,222.76
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $1,062.42 / $1,180.47 / $1,239.49	Professional		$1,062.42	$1,180.47	$1,239.49
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,033.66 / $1,325.72 / $2,305.60	Facility		$1,033.66	$1,325.72	$2,305.60
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $1,123.58 / $1,152.80 / $1,152.80	Facility		$1,123.58	$1,152.80	$1,152.80
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $937.77 / $1,003.40 / $1,298.52	Professional		$937.77	$1,003.40	$1,298.52
United Facility/Professional Professional Modifier Low / Median / High Price $498.37 / $539.03 / $1,028.40	Professional		$498.37	$539.03	$1,028.40
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $586.17 / $586.17 / $654.42	Professional		$586.17	$586.17	$654.42