Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $780.85 / $1,772.53 / $1,850.61	Facility		$780.85	$1,772.53	$1,850.61
Aetna Facility/Professional Professional Modifier Low / Median / High Price $603.39 / $780.85 / $1,850.61	Professional		$603.39	$780.85	$1,850.61
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $1,052.15 / $2,325.48 / $5,814.95	Facility		$1,052.15	$2,325.48	$5,814.95
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $816.08 / $1,051.54 / $6,083.01	Professional		$816.08	$1,051.54	$6,083.01
Cigna Facility/Professional Facility Modifier Low / Median / High Price $895.43 / $895.43 / $895.43	Facility		$895.43	$895.43	$895.43
Cigna Facility/Professional Professional Modifier Low / Median / High Price $653.66 / $653.66 / $895.43	Professional		$653.66	$653.66	$895.43
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $701.61 / $1,201.58 / $3,192.18	Facility		$701.61	$1,201.58	$3,192.18
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $702.38 / $1,225.61 / $2,365.82	Professional		$702.38	$1,225.61	$2,365.82
Molina Facility/Professional Professional Modifier Low / Median / High Price $829.02 / $921.14 / $1,013.25	Professional		$829.02	$921.14	$1,013.25
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $953.79 / $1,173.43 / $1,206.78	Facility		$953.79	$1,173.43	$1,206.78
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $1,081.43 / $1,201.58 / $1,225.61	Professional		$1,081.43	$1,201.58	$1,225.61
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,052.15 / $1,349.44 / $2,346.86	Facility		$1,052.15	$1,349.44	$2,346.86
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $1,143.69 / $1,173.43 / $1,173.43	Facility		$1,143.69	$1,173.43	$1,173.43
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $954.55 / $1,021.35 / $1,321.75	Professional		$954.55	$1,021.35	$1,321.75
United Facility/Professional Professional Modifier Low / Median / High Price $556.23 / $834.35 / $1,061.22	Professional		$556.23	$834.35	$1,061.22
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $610.39 / $610.39 / $686.95	Professional		$610.39	$610.39	$686.95