Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $430.53 / $977.30 / $1,020.36	Facility		$430.53	$977.30	$1,020.36
Aetna Facility/Professional Professional Modifier Low / Median / High Price $289.19 / $430.53 / $1,020.36	Professional		$289.19	$430.53	$1,020.36
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $558.63 / $1,214.89 / $2,780.76	Facility		$558.63	$1,214.89	$2,780.76
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $405.00 / $547.26 / $3,264.96	Professional		$405.00	$547.26	$3,264.96
Cigna Facility/Professional Facility Modifier Low / Median / High Price $347.46 / $347.46 / $347.46	Facility		$347.46	$347.46	$347.46
Cigna Facility/Professional Professional Modifier Low / Median / High Price $253.65 / $253.65 / $347.46	Professional		$253.65	$253.65	$347.46
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $341.12 / $620.15 / $1,652.21	Facility		$341.12	$620.15	$1,652.21
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $342.72 / $620.15 / $1,096.43	Professional		$342.72	$620.15	$1,096.43
Molina Facility/Professional Professional Modifier Low / Median / High Price $440.17 / $489.08 / $537.98	Professional		$440.17	$489.08	$537.98
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $504.31 / $568.04 / $637.97	Facility		$504.31	$568.04	$637.97
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $516.41 / $606.07 / $637.97	Professional		$516.41	$606.07	$637.97
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $558.63 / $716.47 / $1,246.04	Facility		$558.63	$716.47	$1,246.04
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $607.23 / $623.02 / $623.02	Facility		$607.23	$623.02	$623.02
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $506.82 / $542.27 / $701.77	Professional		$506.82	$542.27	$701.77
United Facility/Professional Professional Modifier Low / Median / High Price $238.20 / $300.57 / $491.53	Professional		$238.20	$300.57	$491.53
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $302.39 / $332.95 / $332.95	Professional		$302.39	$332.95	$332.95