Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $405.44 / $920.35 / $960.89	Facility		$405.44	$920.35	$960.89
Aetna Facility/Professional Professional Modifier Low / Median / High Price $302.74 / $405.44 / $960.89	Professional		$302.74	$405.44	$960.89
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $526.07 / $1,149.47 / $2,544.94	Facility		$526.07	$1,149.47	$2,544.94
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $359.73 / $510.67 / $3,633.98	Professional		$359.73	$510.67	$3,633.98
Cigna Facility/Professional Facility Modifier Low / Median / High Price $297.62 / $297.62 / $297.62	Facility		$297.62	$297.62	$297.62
Cigna Facility/Professional Professional Modifier Low / Median / High Price $217.26 / $217.26 / $297.62	Professional		$217.26	$217.26	$297.62
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $299.83 / $571.87 / $1,363.12	Facility		$299.83	$571.87	$1,363.12
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $300.17 / $570.75 / $1,011.20	Professional		$300.17	$570.75	$1,011.20
Molina Facility/Professional Professional Modifier Low / Median / High Price $414.50 / $460.56 / $506.61	Professional		$414.50	$460.56	$506.61
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $476.89 / $540.71 / $600.79	Facility		$476.89	$540.71	$600.79
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $540.61 / $600.79 / $600.79	Professional		$540.61	$600.79	$600.79
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $526.07 / $674.72 / $1,173.42	Facility		$526.07	$674.72	$1,173.42
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $571.84 / $586.71 / $586.71	Facility		$571.84	$586.71	$586.71
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $477.26 / $510.67 / $660.87	Professional		$477.26	$510.67	$660.87
United Facility/Professional Professional Modifier Low / Median / High Price $219.70 / $256.32 / $453.35	Professional		$219.70	$256.32	$453.35
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $173.82 / $173.82 / $289.64	Professional		$173.82	$173.82	$289.64