Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $613.30 / $1,392.21 / $1,453.54	Facility		$613.30	$1,392.21	$1,453.54
Aetna Facility/Professional Professional Modifier Low / Median / High Price $545.16 / $613.30 / $1,453.54	Professional		$545.16	$613.30	$1,453.54
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $795.78 / $2,360.78 / $4,877.45	Facility		$795.78	$2,360.78	$4,877.45
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $663.42 / $795.78 / $5,852.00	Professional		$663.42	$795.78	$5,852.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $567.88 / $567.88 / $567.88	Facility		$567.88	$567.88	$567.88
Cigna Facility/Professional Professional Modifier Low / Median / High Price $414.55 / $414.55 / $742.22	Professional		$414.55	$414.55	$742.22
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $571.92 / $966.63 / $2,490.32	Facility		$571.92	$966.63	$2,490.32
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $572.55 / $973.74 / $1,928.90	Professional		$572.55	$973.74	$1,928.90
Molina Facility/Professional Professional Modifier Low / Median / High Price $627.02 / $696.69 / $766.35	Professional		$627.02	$696.69	$766.35
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $721.39 / $887.51 / $1,175.09	Facility		$721.39	$887.51	$1,175.09
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $817.92 / $908.80 / $1,175.09	Professional		$817.92	$908.80	$1,175.09
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $795.78 / $1,020.64 / $1,775.02	Facility		$795.78	$1,020.64	$1,775.02
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $865.01 / $887.51 / $887.51	Facility		$865.01	$887.51	$887.51
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $721.96 / $772.48 / $999.68	Professional		$721.96	$772.48	$999.68
United Facility/Professional Professional Modifier Low / Median / High Price $419.20 / $454.13 / $865.01	Professional		$419.20	$454.13	$865.01
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $523.53 / $523.53 / $553.50	Professional		$523.53	$523.53	$553.50