Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $728.53 / $1,653.76 / $1,726.62	Facility		$728.53	$1,653.76	$1,726.62
Aetna Facility/Professional Professional Modifier Low / Median / High Price $543.40 / $728.53 / $1,726.62	Professional		$543.40	$728.53	$1,726.62
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $945.29 / $2,359.85 / $5,145.80	Facility		$945.29	$2,359.85	$5,145.80
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $756.30 / $945.29 / $6,210.34	Professional		$756.30	$945.29	$6,210.34
Cigna Facility/Professional Facility Modifier Low / Median / High Price $751.98 / $751.98 / $751.98	Facility		$751.98	$751.98	$751.98
Cigna Facility/Professional Professional Modifier Low / Median / High Price $548.95 / $548.95 / $751.98	Professional		$548.95	$548.95	$751.98
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $610.61 / $1,079.55 / $2,777.81	Facility		$610.61	$1,079.55	$2,777.81
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $611.28 / $1,079.55 / $2,058.82	Professional		$611.28	$1,079.55	$2,058.82
Molina Facility/Professional Professional Modifier Low / Median / High Price $744.82 / $827.58 / $910.33	Professional		$744.82	$827.58	$910.33
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $856.91 / $971.60 / $1,079.55	Facility		$856.91	$971.60	$1,079.55
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $917.62 / $971.60 / $1,079.55	Professional		$917.62	$971.60	$1,079.55
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $945.29 / $1,212.39 / $2,108.50	Facility		$945.29	$1,212.39	$2,108.50
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $1,027.53 / $1,054.25 / $1,054.25	Facility		$1,027.53	$1,054.25	$1,054.25
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $857.60 / $917.62 / $1,187.51	Professional		$857.60	$917.62	$1,187.51
United Facility/Professional Facility Modifier Low / Median / High Price $373.00 / $479.78 / $522.19	Facility		$373.00	$479.78	$522.19
United Facility/Professional Professional Modifier Low / Median / High Price $447.59 / $484.89 / $923.61	Professional		$447.59	$484.89	$923.61
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $359.08 / $359.08 / $917.62	Professional		$359.08	$359.08	$917.62