Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $513.52 / $1,165.69 / $1,217.04	Facility		$513.52	$1,165.69	$1,217.04
Aetna Facility/Professional Professional Modifier Low / Median / High Price $480.60 / $513.52 / $1,217.04	Professional		$480.60	$513.52	$1,217.04
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $691.93 / $1,504.80 / $4,115.68	Facility		$691.93	$1,504.80	$4,115.68
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $535.45 / $671.68 / $5,246.98	Professional		$535.45	$671.68	$5,246.98
Cigna Facility/Professional Facility Modifier Low / Median / High Price $589.44 / $589.44 / $589.44	Facility		$589.44	$589.44	$589.44
Cigna Facility/Professional Professional Modifier Low / Median / High Price $430.29 / $430.29 / $589.44	Professional		$430.29	$430.29	$589.44
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $497.31 / $840.51 / $2,165.36	Facility		$497.31	$840.51	$2,165.36
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $497.86 / $846.33 / $1,676.51	Professional		$497.86	$846.33	$1,676.51
Molina Facility/Professional Professional Modifier Low / Median / High Price $545.20 / $605.78 / $666.35	Professional		$545.20	$605.78	$666.35
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $627.25 / $771.69 / $1,053.60	Facility		$627.25	$771.69	$1,053.60
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $627.75 / $790.21 / $1,053.60	Professional		$627.75	$790.21	$1,053.60
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $691.93 / $887.44 / $1,543.38	Facility		$691.93	$887.44	$1,543.38
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $752.13 / $771.69 / $771.69	Facility		$752.13	$771.69	$771.69
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $627.75 / $671.68 / $869.23	Professional		$627.75	$671.68	$869.23
United Facility/Professional Professional Modifier Low / Median / High Price $394.23 / $565.57 / $752.13	Professional		$394.23	$565.57	$752.13
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $226.90 / $226.90 / $482.76	Professional		$226.90	$226.90	$482.76