Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $493.16 / $939.00 / $1,168.79	Facility		$493.16	$939.00	$1,168.79
Aetna Facility/Professional Professional Modifier Low / Median / High Price $375.31 / $493.16 / $1,168.79	Professional		$375.31	$493.16	$1,168.79
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $664.49 / $1,589.42 / $3,853.16	Facility		$664.49	$1,589.42	$3,853.16
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $548.28 / $733.02 / $5,024.43	Professional		$548.28	$733.02	$5,024.43
Cigna Facility/Professional Facility Modifier Low / Median / High Price $485.57 / $485.57 / $485.57	Facility		$485.57	$485.57	$485.57
Cigna Facility/Professional Professional Modifier Low / Median / High Price $354.47 / $354.47 / $485.57	Professional		$354.47	$354.47	$485.57
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $472.29 / $803.87 / $2,079.51	Facility		$472.29	$803.87	$2,079.51
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $472.80 / $804.14 / $1,592.93	Professional		$472.80	$804.14	$1,592.93
Molina Facility/Professional Professional Modifier Low / Median / High Price $523.58 / $581.76 / $639.93	Professional		$523.58	$581.76	$639.93
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $602.38 / $741.08 / $758.87	Facility		$602.38	$741.08	$758.87
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $645.04 / $758.87 / $758.87	Professional		$645.04	$758.87	$758.87
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $664.49 / $852.24 / $1,482.16	Facility		$664.49	$852.24	$1,482.16
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $722.30 / $741.08 / $741.08	Facility		$722.30	$741.08	$741.08
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $602.86 / $645.04 / $834.76	Professional		$602.86	$645.04	$834.76
United Facility/Professional Professional Modifier Low / Median / High Price $374.47 / $561.71 / $714.45	Professional		$374.47	$561.71	$714.45
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $208.16 / $208.16 / $456.56	Professional		$208.16	$208.16	$456.56