Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $794.16 / $5,261.08 / $5,524.18	Facility		$794.16	$5,261.08	$5,524.18
Aetna Facility/Professional Professional Modifier Low / Median / High Price $626.35 / $794.16 / $1,802.74	Professional		$626.35	$794.16	$1,802.74
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $1,030.45 / $2,745.45 / $5,627.79	Facility		$1,030.45	$2,745.45	$5,627.79
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $829.52 / $1,023.82 / $6,674.40	Professional		$829.52	$1,023.82	$6,674.40
Cigna Facility/Professional Facility Modifier Low / Median / High Price $769.23 / $769.23 / $769.23	Facility		$769.23	$769.23	$769.23
Cigna Facility/Professional Professional Modifier Low / Median / High Price $561.54 / $561.54 / $831.55	Professional		$561.54	$561.54	$831.55
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $656.11 / $1,176.80 / $2,985.93	Facility		$656.11	$1,176.80	$2,985.93
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $656.83 / $1,176.80 / $2,213.56	Professional		$656.83	$1,176.80	$2,213.56
Molina Facility/Professional Professional Modifier Low / Median / High Price $811.93 / $902.15 / $992.36	Professional		$811.93	$902.15	$992.36
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $934.11 / $1,073.03 / $1,176.80	Facility		$934.11	$1,073.03	$1,176.80
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $1,000.28 / $1,176.80 / $1,176.80	Professional		$1,000.28	$1,176.80	$1,176.80
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,030.45 / $1,321.60 / $2,298.44	Facility		$1,030.45	$1,321.60	$2,298.44
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $1,120.09 / $1,149.22 / $1,149.22	Facility		$1,120.09	$1,149.22	$1,149.22
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $934.87 / $1,000.28 / $1,294.48	Professional		$934.87	$1,000.28	$1,294.48
United Facility/Professional Professional Modifier Low / Median / High Price $481.04 / $520.28 / $992.62	Professional		$481.04	$520.28	$992.62
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $643.32 / $676.53 / $676.53	Professional		$643.32	$676.53	$676.53