Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $419.14 / $951.45 / $993.36	Facility		$419.14	$951.45	$993.36
Aetna Facility/Professional Professional Modifier Low / Median / High Price $295.89 / $419.14 / $993.36	Professional		$295.89	$419.14	$993.36
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $564.77 / $1,383.28 / $3,128.35	Facility		$564.77	$1,383.28	$3,128.35
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $465.96 / $564.77 / $4,372.97	Professional		$465.96	$564.77	$4,372.97
Cigna Facility/Professional Facility Modifier Low / Median / High Price $400.78 / $400.78 / $400.78	Facility		$400.78	$400.78	$400.78
Cigna Facility/Professional Professional Modifier Low / Median / High Price $292.57 / $292.57 / $400.78	Professional		$292.57	$292.57	$400.78
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $372.19 / $644.98 / $1,694.06	Facility		$372.19	$644.98	$1,694.06
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $372.59 / $654.15 / $1,255.31	Professional		$372.59	$654.15	$1,255.31
Molina Facility/Professional Professional Modifier Low / Median / High Price $445.01 / $494.46 / $543.90	Professional		$445.01	$494.46	$543.90
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $511.98 / $591.78 / $644.98	Facility		$511.98	$591.78	$644.98
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $512.39 / $644.98 / $644.98	Professional		$512.39	$644.98	$644.98
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $564.77 / $724.34 / $1,259.72	Facility		$564.77	$724.34	$1,259.72
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $613.90 / $629.86 / $629.86	Facility		$613.90	$629.86	$629.86
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $512.39 / $548.23 / $709.48	Professional		$512.39	$548.23	$709.48
United Facility/Professional Professional Modifier Low / Median / High Price $295.24 / $444.73 / $563.27	Professional		$295.24	$444.73	$563.27
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $271.14 / $271.14 / $359.88	Professional		$271.14	$271.14	$359.88