Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $796.64 / $1,808.37 / $1,888.04	Facility		$796.64	$1,808.37	$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 $782.41 / $782.41 / $782.41	Facility		$782.41	$782.41	$782.41
Cigna Facility/Professional Professional Modifier Low / Median / High Price $571.16 / $571.16 / $782.41	Professional		$571.16	$571.16	$782.41
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 $60.00 / $60.00 / $60.00	Professional		$60.00	$60.00	$60.00
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 / $1,222.76	Professional		$1,062.42	$1,180.47	$1,222.76
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 $244.14 / $244.14 / $657.04	Professional		$244.14	$244.14	$657.04