Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $628.20 / $1,426.01 / $1,488.83	Facility		$628.20	$1,426.01	$1,488.83
Aetna Facility/Professional Professional Modifier Low / Median / High Price $458.26 / $628.20 / $1,488.83	Professional		$458.26	$628.20	$1,488.83
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $815.11 / $1,972.65 / $4,380.81	Facility		$815.11	$1,972.65	$4,380.81
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $651.62 / $809.87 / $5,237.28	Professional		$651.62	$809.87	$5,237.28
Cigna Facility/Professional Facility Modifier Low / Median / High Price $511.34 / $511.34 / $511.34	Facility		$511.34	$511.34	$511.34
Cigna Facility/Professional Professional Modifier Low / Median / High Price $373.28 / $373.28 / $511.34	Professional		$373.28	$373.28	$511.34
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $515.05 / $930.88 / $2,343.75	Facility		$515.05	$930.88	$2,343.75
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $515.62 / $930.88 / $1,736.09	Professional		$515.62	$930.88	$1,736.09
Molina Facility/Professional Professional Modifier Low / Median / High Price $642.25 / $713.62 / $784.98	Professional		$642.25	$713.62	$784.98
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $738.90 / $837.79 / $930.88	Facility		$738.90	$837.79	$930.88
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $739.50 / $930.88 / $930.88	Professional		$739.50	$930.88	$930.88
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $815.11 / $1,045.42 / $1,818.12	Facility		$815.11	$1,045.42	$1,818.12
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $886.02 / $909.06 / $909.06	Facility		$886.02	$909.06	$909.06
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $739.50 / $791.25 / $1,023.97	Professional		$739.50	$791.25	$1,023.97
United Facility/Professional Facility Modifier Low / Median / High Price $6.52 / $404.62 / $408.26	Facility		$6.52	$404.62	$408.26
United Facility/Professional Professional Modifier Low / Median / High Price $377.47 / $408.92 / $778.90	Professional		$377.47	$408.92	$778.90
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $359.08 / $359.08 / $488.42	Professional		$359.08	$359.08	$488.42