Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $399.37 / $760.00 / $946.51	Facility		$399.37	$760.00	$946.51
Aetna Facility/Professional Professional Modifier Low / Median / High Price $307.27 / $399.37 / $946.51	Professional		$307.27	$399.37	$946.51
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $538.12 / $1,337.19 / $3,241.88	Facility		$538.12	$1,337.19	$3,241.88
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $448.62 / $600.15 / $4,227.08	Professional		$448.62	$600.15	$4,227.08
Cigna Facility/Professional Facility Modifier Low / Median / High Price $452.18 / $452.18 / $452.18	Facility		$452.18	$452.18	$452.18
Cigna Facility/Professional Professional Modifier Low / Median / High Price $330.09 / $330.09 / $452.18	Professional		$330.09	$330.09	$452.18
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $386.75 / $653.65 / $1,684.04	Facility		$386.75	$653.65	$1,684.04
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $387.17 / $658.16 / $1,304.14	Professional		$387.17	$658.16	$1,304.14
Molina Facility/Professional Professional Modifier Low / Median / High Price $424.00 / $471.12 / $518.23	Professional		$424.00	$471.12	$518.23
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $487.81 / $600.15 / $614.54	Facility		$487.81	$600.15	$614.54
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $583.82 / $614.54 / $676.01	Professional		$583.82	$614.54	$676.01
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $538.12 / $690.17 / $1,200.30	Facility		$538.12	$690.17	$1,200.30
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $584.94 / $600.15 / $600.15	Facility		$584.94	$600.15	$600.15
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $488.21 / $522.37 / $676.01	Professional		$488.21	$522.37	$676.01
United Facility/Professional Facility Modifier Low / Median / High Price $819.40 / $983.28 / $983.28	Facility		$819.40	$983.28	$983.28
United Facility/Professional Professional Modifier Low / Median / High Price $306.58 / $410.63 / $584.94	Professional		$306.58	$410.63	$584.94
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $213.37 / $213.37 / $373.72	Professional		$213.37	$213.37	$373.72