Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $456.42 / $1,036.07 / $1,081.72	Facility		$456.42	$1,036.07	$1,081.72
Aetna Facility/Professional Professional Modifier Low / Median / High Price $405.71 / $456.42 / $1,081.72	Professional		$405.71	$456.42	$1,081.72
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $384.24 / $1,089.22 / $3,899.19	Facility		$384.24	$1,089.22	$3,899.19
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $326.60 / $572.62 / $2,632.88	Professional		$326.60	$572.62	$2,632.88
Cigna Facility/Professional Facility Modifier Low / Median / High Price $854.15 / $854.15 / $854.15	Facility		$854.15	$854.15	$854.15
Cigna Facility/Professional Professional Modifier Low / Median / High Price $623.53 / $623.53 / $854.15	Professional		$623.53	$623.53	$854.15
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $375.97 / $1,477.34 / $3,775.96	Facility		$375.97	$1,477.34	$3,775.96
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $375.97 / $1,430.20 / $2,516.46	Professional		$375.97	$1,430.20	$2,516.46
Molina Facility/Professional Professional Modifier Low / Median / High Price $911.95 / $1,013.28 / $1,114.60	Professional		$911.95	$1,013.28	$1,114.60
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $395.76 / $589.79 / $1,110.11	Facility		$395.76	$589.79	$1,110.11
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $1,050.03 / $1,050.03 / $1,050.03	Professional		$1,050.03	$1,050.03	$1,050.03
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $326.60 / $577.52 / $768.48	Facility		$326.60	$577.52	$768.48
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $326.60 / $567.41 / $1,114.98	Professional		$326.60	$567.41	$1,114.98
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $384.24 / $384.24 / $602.69	Facility		$384.24	$384.24	$602.69
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $319.58 / $340.35 / $1,050.03	Professional		$319.58	$340.35	$1,050.03
United Facility/Professional Professional Modifier Low / Median / High Price $599.75 / $630.26 / $1,050.44	Professional		$599.75	$630.26	$1,050.44
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $800.91 / $800.91 / $800.91	Professional		$800.91	$800.91	$800.91