Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $516.76 / $1,173.05 / $1,224.72	Facility		$516.76	$1,173.05	$1,224.72
Aetna Facility/Professional Professional Modifier Low / Median / High Price $402.23 / $516.76 / $1,224.72	Professional		$402.23	$516.76	$1,224.72
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $670.52 / $1,712.40 / $3,769.74	Facility		$670.52	$1,712.40	$3,769.74
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $553.27 / $701.42 / $5,413.46	Professional		$553.27	$701.42	$5,413.46
Cigna Facility/Professional Facility Modifier Low / Median / High Price $512.80 / $512.80 / $512.80	Facility		$512.80	$512.80	$512.80
Cigna Facility/Professional Professional Modifier Low / Median / High Price $374.35 / $374.35 / $512.80	Professional		$374.35	$374.35	$512.80
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $474.24 / $781.08 / $2,055.92	Facility		$474.24	$781.08	$2,055.92
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $476.64 / $794.10 / $1,524.25	Professional		$476.64	$794.10	$1,524.25
Molina Facility/Professional Professional Modifier Low / Median / High Price $528.32 / $587.03 / $645.73	Professional		$528.32	$587.03	$645.73
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $607.84 / $718.26 / $765.76	Facility		$607.84	$718.26	$765.76
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $650.90 / $765.76 / $781.08	Professional		$650.90	$765.76	$781.08
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $670.52 / $859.98 / $1,495.62	Facility		$670.52	$859.98	$1,495.62
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $728.86 / $747.81 / $747.81	Facility		$728.86	$747.81	$747.81
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $608.32 / $650.90 / $842.34	Professional		$608.32	$650.90	$842.34
United Facility/Professional Professional Modifier Low / Median / High Price $331.31 / $358.92 / $683.65	Professional		$331.31	$358.92	$683.65
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $437.46 / $474.04 / $474.04	Professional		$437.46	$474.04	$474.04