Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $764.28 / $1,734.92 / $1,811.34	Facility		$764.28	$1,734.92	$1,811.34
Aetna Facility/Professional Professional Modifier Low / Median / High Price $656.60 / $764.28 / $1,811.34	Professional		$656.60	$764.28	$1,811.34
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $991.68 / $3,226.56 / $5,394.87	Facility		$991.68	$3,226.56	$5,394.87
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $766.13 / $991.68 / $10,200.24	Professional		$766.13	$991.68	$10,200.24
Cigna Facility/Professional Facility Modifier Low / Median / High Price $627.26 / $627.26 / $627.26	Facility		$627.26	$627.26	$627.26
Cigna Facility/Professional Professional Modifier Low / Median / High Price $457.90 / $457.90 / $635.41	Professional		$457.90	$457.90	$635.41
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $631.54 / $1,132.53 / $2,874.37	Facility		$631.54	$1,132.53	$2,874.37
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $632.23 / $1,132.53 / $2,129.98	Professional		$632.23	$1,132.53	$2,129.98
Molina Facility/Professional Professional Modifier Low / Median / High Price $781.38 / $868.21 / $955.03	Professional		$781.38	$868.21	$955.03
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $898.96 / $1,105.99 / $1,172.50	Facility		$898.96	$1,105.99	$1,172.50
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $899.70 / $1,132.53 / $1,172.50	Professional		$899.70	$1,132.53	$1,172.50
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $991.68 / $1,271.89 / $2,211.98	Facility		$991.68	$1,271.89	$2,211.98
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $1,077.96 / $1,105.99 / $1,105.99	Facility		$1,077.96	$1,105.99	$1,105.99
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $899.70 / $962.65 / $1,245.78	Professional		$899.70	$962.65	$1,245.78
United Facility/Professional Facility Modifier Low / Median / High Price $385.87 / $496.34 / $641.24	Facility		$385.87	$496.34	$641.24
United Facility/Professional Professional Modifier Low / Median / High Price $463.04 / $501.62 / $955.48	Professional		$463.04	$501.62	$955.48
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $390.30 / $390.30 / $604.41	Professional		$390.30	$390.30	$604.41