Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $383.92 / $871.50 / $909.89	Facility		$383.92	$871.50	$909.89
Aetna Facility/Professional Professional Modifier Low / Median / High Price $330.00 / $383.92 / $909.89	Professional		$330.00	$383.92	$909.89
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $472.23 / $972.25 / $2,714.31	Facility		$472.23	$972.25	$2,714.31
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $405.13 / $498.15 / $2,934.66	Professional		$405.13	$498.15	$2,934.66
Cigna Facility/Professional Facility Modifier Low / Median / High Price $325.37 / $325.37 / $325.37	Facility		$325.37	$325.37	$325.37
Cigna Facility/Professional Professional Modifier Low / Median / High Price $237.52 / $237.52 / $370.96	Professional		$237.52	$237.52	$370.96
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $413.85 / $654.24 / $1,625.20	Facility		$413.85	$654.24	$1,625.20
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $413.85 / $647.48 / $1,122.92	Professional		$413.85	$647.48	$1,122.92
Molina Facility/Professional Professional Modifier Low / Median / High Price $392.50 / $436.12 / $479.73	Professional		$392.50	$436.12	$479.73
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $555.57 / $568.90 / $589.29	Facility		$555.57	$568.90	$589.29
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $451.94 / $451.94 / $451.94	Professional		$451.94	$451.94	$451.94
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $472.23 / $498.15 / $1,083.35	Facility		$472.23	$498.15	$1,083.35
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $472.23 / $514.41 / $638.91	Professional		$472.23	$514.41	$638.91
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $541.49 / $555.57 / $555.57	Facility		$541.49	$555.57	$555.57
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $451.94 / $483.57 / $625.79	Professional		$451.94	$483.57	$625.79
United Facility/Professional Professional Modifier Low / Median / High Price $259.77 / $285.27 / $495.62	Professional		$259.77	$285.27	$495.62
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $325.80 / $483.56 / $483.56	Professional		$325.80	$483.56	$483.56