Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $393.25 / $892.68 / $932.00	Facility		$393.25	$892.68	$932.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $301.99 / $393.25 / $932.00	Professional		$301.99	$393.25	$932.00
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $529.88 / $1,207.97 / $3,226.39	Facility		$529.88	$1,207.97	$3,226.39
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $437.21 / $540.09 / $3,986.28	Professional		$437.21	$540.09	$3,986.28
Cigna Facility/Professional Facility Modifier Low / Median / High Price $427.13 / $427.13 / $427.13	Facility		$427.13	$427.13	$427.13
Cigna Facility/Professional Professional Modifier Low / Median / High Price $311.80 / $311.80 / $427.13	Professional		$311.80	$311.80	$427.13
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $379.92 / $642.11 / $1,658.27	Facility		$379.92	$642.11	$1,658.27
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $380.34 / $647.19 / $1,280.97	Professional		$380.34	$647.19	$1,280.97
Molina Facility/Professional Professional Modifier Low / Median / High Price $417.51 / $463.90 / $510.29	Professional		$417.51	$463.90	$510.29
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $480.35 / $590.96 / $605.14	Facility		$480.35	$590.96	$605.14
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $544.63 / $605.14 / $605.14	Professional		$544.63	$605.14	$605.14
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $529.88 / $679.60 / $1,181.92	Facility		$529.88	$679.60	$1,181.92
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $575.98 / $590.96 / $590.96	Facility		$575.98	$590.96	$590.96
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $480.73 / $514.37 / $665.65	Professional		$480.73	$514.37	$665.65
United Facility/Professional Professional Modifier Low / Median / High Price $301.32 / $453.89 / $574.88	Professional		$301.32	$453.89	$574.88
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $218.57 / $218.57 / $368.99	Professional		$218.57	$218.57	$368.99