Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $514.36 / $1,167.59 / $1,219.03	Facility		$514.36	$1,167.59	$1,219.03
Aetna Facility/Professional Professional Modifier Low / Median / High Price $472.61 / $514.36 / $1,219.03	Professional		$472.61	$514.36	$1,219.03
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $693.07 / $1,439.09 / $3,692.24	Facility		$693.07	$1,439.09	$3,692.24
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $496.24 / $688.61 / $4,707.20	Professional		$496.24	$688.61	$4,707.20
Cigna Facility/Professional Facility Modifier Low / Median / High Price $458.59 / $458.59 / $458.59	Facility		$458.59	$458.59	$458.59
Cigna Facility/Professional Professional Modifier Low / Median / High Price $334.77 / $334.77 / $458.59	Professional		$334.77	$334.77	$458.59
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $445.90 / $791.51 / $2,029.68	Facility		$445.90	$791.51	$2,029.68
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $446.39 / $791.51 / $1,504.39	Professional		$446.39	$791.51	$1,504.39
Molina Facility/Professional Professional Modifier Low / Median / High Price $546.10 / $606.78 / $667.45	Professional		$546.10	$606.78	$667.45
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $628.29 / $772.96 / $945.22	Facility		$628.29	$772.96	$945.22
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $712.36 / $791.51 / $945.22	Professional		$712.36	$791.51	$945.22
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $693.07 / $888.90 / $1,545.92	Facility		$693.07	$888.90	$1,545.92
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $753.37 / $772.96 / $772.96	Facility		$753.37	$772.96	$772.96
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $628.79 / $672.78 / $870.66	Professional		$628.79	$672.78	$870.66
United Facility/Professional Professional Modifier Low / Median / High Price $353.67 / $507.38 / $674.75	Professional		$353.67	$507.38	$674.75
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $104.08 / $104.08 / $433.10	Professional		$104.08	$104.08	$433.10