Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $814.70 / $1,849.37 / $1,930.84	Facility		$814.70	$1,849.37	$1,930.84
Aetna Facility/Professional Professional Modifier Low / Median / High Price $663.79 / $814.70 / $1,121.59	Professional		$663.79	$814.70	$1,121.59
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $1,057.09 / $2,510.83 / $5,761.13	Facility		$1,057.09	$2,510.83	$5,761.13
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $661.43 / $1,050.30 / $6,239.69	Professional		$661.43	$1,050.30	$6,239.69
Cigna Facility/Professional Facility Modifier Low / Median / High Price $756.07 / $756.07 / $756.07	Facility		$756.07	$756.07	$756.07
Cigna Facility/Professional Professional Modifier Low / Median / High Price $551.92 / $551.92 / $825.98	Professional		$551.92	$551.92	$825.98
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $775.00 / $1,326.25 / $3,165.00	Facility		$775.00	$1,326.25	$3,165.00
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $775.00 / $1,278.83 / $2,345.13	Professional		$775.00	$1,278.83	$2,345.13
Molina Facility/Professional Professional Modifier Low / Median / High Price $832.92 / $925.47 / $1,018.01	Professional		$832.92	$925.47	$1,018.01
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $958.28 / $1,178.95 / $1,252.95	Facility		$958.28	$1,178.95	$1,252.95
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $1,086.52 / $1,207.24 / $1,252.95	Professional		$1,086.52	$1,207.24	$1,252.95
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,057.09 / $1,355.79 / $2,357.90	Facility		$1,057.09	$1,355.79	$2,357.90
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $1,149.07 / $1,178.95 / $1,178.95	Facility		$1,149.07	$1,178.95	$1,178.95
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $959.04 / $1,026.15 / $1,327.96	Professional		$959.04	$1,026.15	$1,327.96
United Facility/Professional Professional Modifier Low / Median / High Price $509.80 / $552.28 / $1,051.97	Professional		$509.80	$552.28	$1,051.97
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $661.43 / $891.58 / $891.58	Professional		$661.43	$891.58	$891.58