Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $838.60 / $1,903.62 / $1,987.48	Facility		$838.60	$1,903.62	$1,987.48
Aetna Facility/Professional Professional Modifier Low / Median / High Price $603.89 / $838.60 / $1,987.48	Professional		$603.89	$838.60	$1,987.48
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $1,088.10 / $2,737.40 / $5,716.25	Facility		$1,088.10	$2,737.40	$5,716.25
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $656.78 / $1,056.25 / $8,653.64	Professional		$656.78	$1,056.25	$8,653.64
Cigna Facility/Professional Facility Modifier Low / Median / High Price $711.81 / $711.81 / $711.81	Facility		$711.81	$711.81	$711.81
Cigna Facility/Professional Professional Modifier Low / Median / High Price $519.62 / $519.62 / $762.07	Professional		$519.62	$519.62	$762.07
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $756.40 / $1,294.42 / $3,218.23	Facility		$756.40	$1,294.42	$3,218.23
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $756.40 / $1,272.11 / $2,288.03	Professional		$756.40	$1,272.11	$2,288.03
Molina Facility/Professional Professional Modifier Low / Median / High Price $857.36 / $952.63 / $1,047.89	Professional		$857.36	$952.63	$1,047.89
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $986.39 / $1,118.39 / $1,242.65	Facility		$986.39	$1,118.39	$1,242.65
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $1,078.36 / $1,242.65 / $1,366.92	Professional		$1,078.36	$1,242.65	$1,366.92
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,088.10 / $1,395.56 / $2,427.06	Facility		$1,088.10	$1,395.56	$2,427.06
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $1,182.78 / $1,213.53 / $1,213.53	Facility		$1,182.78	$1,213.53	$1,213.53
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $987.18 / $1,056.25 / $1,366.92	Professional		$987.18	$1,056.25	$1,366.92
United Facility/Professional Professional Modifier Low / Median / High Price $497.41 / $549.74 / $1,026.40	Professional		$497.41	$549.74	$1,026.40
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $656.78 / $656.78 / $656.78	Professional		$656.78	$656.78	$656.78