Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $426.52 / $968.20 / $1,010.85	Facility		$426.52	$968.20	$1,010.85
Aetna Facility/Professional Professional Modifier Low / Median / High Price $286.13 / $426.52 / $1,010.85	Professional		$286.13	$426.52	$1,010.85
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $574.71 / $1,281.85 / $3,080.66	Facility		$574.71	$1,281.85	$3,080.66
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $448.87 / $564.44 / $3,353.09	Professional		$448.87	$564.44	$3,353.09
Cigna Facility/Professional Facility Modifier Low / Median / High Price $493.58 / $493.58 / $493.58	Facility		$493.58	$493.58	$493.58
Cigna Facility/Professional Professional Modifier Low / Median / High Price $360.31 / $360.31 / $493.58	Professional		$360.31	$360.31	$493.58
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $359.90 / $656.33 / $1,638.75	Facility		$359.90	$656.33	$1,638.75
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $360.30 / $656.33 / $1,213.94	Professional		$360.30	$656.33	$1,213.94
Molina Facility/Professional Professional Modifier Low / Median / High Price $452.83 / $503.15 / $553.46	Professional		$452.83	$503.15	$553.46
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $520.98 / $590.70 / $656.33	Facility		$520.98	$590.70	$656.33
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $529.76 / $656.33 / $656.33	Professional		$529.76	$656.33	$656.33
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $574.71 / $737.09 / $1,281.90	Facility		$574.71	$737.09	$1,281.90
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $624.71 / $640.95 / $640.95	Facility		$624.71	$640.95	$640.95
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $521.40 / $557.88 / $721.96	Professional		$521.40	$557.88	$721.96
United Facility/Professional Facility Modifier Low / Median / High Price $763.01 / $915.61 / $915.61	Facility		$763.01	$915.61	$915.61
United Facility/Professional Professional Modifier Low / Median / High Price $285.49 / $430.06 / $544.67	Professional		$285.49	$430.06	$544.67
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $182.14 / $182.14 / $345.85	Professional		$182.14	$182.14	$345.85