Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $644.33 / $1,462.63 / $1,527.06	Facility		$644.33	$1,462.63	$1,527.06
Aetna Facility/Professional Professional Modifier Low / Median / High Price $495.76 / $644.33 / $1,527.06	Professional		$495.76	$644.33	$1,527.06
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $868.20 / $1,791.30 / $3,873.08	Facility		$868.20	$1,791.30	$3,873.08
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $544.54 / $842.78 / $4,937.72	Professional		$544.54	$842.78	$4,937.72
Cigna Facility/Professional Facility Modifier Low / Median / High Price $530.41 / $530.41 / $530.41	Facility		$530.41	$530.41	$530.41
Cigna Facility/Professional Professional Modifier Low / Median / High Price $387.20 / $387.20 / $530.41	Professional		$387.20	$387.20	$530.41
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $467.74 / $941.93 / $2,130.00	Facility		$467.74	$941.93	$2,130.00
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $468.25 / $941.93 / $1,578.04	Professional		$468.25	$941.93	$1,578.04
Molina Facility/Professional Professional Modifier Low / Median / High Price $684.08 / $760.09 / $836.09	Professional		$684.08	$760.09	$836.09
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $787.04 / $968.27 / $991.51	Facility		$787.04	$968.27	$991.51
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $892.36 / $991.51 / $991.51	Professional		$892.36	$991.51	$991.51
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $868.20 / $1,113.51 / $1,936.54	Facility		$868.20	$1,113.51	$1,936.54
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $943.73 / $968.27 / $968.27	Facility		$943.73	$968.27	$968.27
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $787.66 / $842.78 / $1,090.66	Professional		$787.66	$842.78	$1,090.66
United Facility/Professional Professional Modifier Low / Median / High Price $370.99 / $558.84 / $707.80	Professional		$370.99	$558.84	$707.80
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $398.63 / $398.63 / $454.30	Professional		$398.63	$398.63	$454.30