Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $649.00 / $808.75 / $1,525.94	Facility		$649.00	$808.75	$1,525.94
Aetna Facility/Professional Professional Modifier Low / Median / High Price $306.38 / $344.79 / $782.67	Professional		$306.38	$344.79	$782.67
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $447.38 / $1,327.18 / $2,665.73	Facility		$447.38	$1,327.18	$2,665.73
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $369.13 / $498.18 / $3,489.30	Professional		$369.13	$498.18	$3,489.30
Cigna Facility/Professional Facility Modifier Low / Median / High Price $361.45 / $361.45 / $361.45	Facility		$361.45	$361.45	$361.45
Cigna Facility/Professional Professional Modifier Low / Median / High Price $263.86 / $263.86 / $361.45	Professional		$263.86	$263.86	$361.45
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $320.77 / $542.14 / $1,399.99	Facility		$320.77	$542.14	$1,399.99
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $321.12 / $546.78 / $1,082.36	Professional		$321.12	$546.78	$1,082.36
Molina Facility/Professional Professional Modifier Low / Median / High Price $352.49 / $391.66 / $430.82	Professional		$352.49	$391.66	$430.82
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $405.55 / $498.94 / $510.91	Facility		$405.55	$498.94	$510.91
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $405.87 / $510.91 / $510.91	Professional		$405.87	$510.91	$510.91
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $447.38 / $573.78 / $997.88	Facility		$447.38	$573.78	$997.88
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $486.30 / $498.94 / $498.94	Facility		$486.30	$498.94	$498.94
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $405.87 / $434.27 / $562.00	Professional		$405.87	$434.27	$562.00
United Facility/Professional Professional Modifier Low / Median / High Price $235.31 / $254.92 / $485.55	Professional		$235.31	$254.92	$485.55
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $260.20 / $260.20 / $307.66	Professional		$260.20	$260.20	$307.66