Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $773.92 / $1,756.80 / $1,834.19	Facility		$773.92	$1,756.80	$1,834.19
Aetna Facility/Professional Professional Modifier Low / Median / High Price $595.38 / $773.92 / $1,834.19	Professional		$595.38	$773.92	$1,834.19
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $1,042.81 / $2,268.19 / $5,705.72	Facility		$1,042.81	$2,268.19	$5,705.72
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $800.00 / $1,042.19 / $5,933.16	Professional		$800.00	$1,042.19	$5,933.16
Cigna Facility/Professional Facility Modifier Low / Median / High Price $957.73 / $957.73 / $957.73	Facility		$957.73	$957.73	$957.73
Cigna Facility/Professional Professional Modifier Low / Median / High Price $699.14 / $699.14 / $957.73	Professional		$699.14	$699.14	$957.73
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $688.41 / $1,190.91 / $3,132.18	Facility		$688.41	$1,190.91	$3,132.18
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $689.17 / $1,209.94 / $2,321.13	Professional		$689.17	$1,209.94	$2,321.13
Molina Facility/Professional Professional Modifier Low / Median / High Price $821.67 / $912.97 / $1,004.26	Professional		$821.67	$912.97	$1,004.26
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $945.33 / $1,163.00 / $1,190.91	Facility		$945.33	$1,163.00	$1,190.91
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $1,071.82 / $1,190.91 / $1,190.91	Professional		$1,071.82	$1,190.91	$1,190.91
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,042.81 / $1,337.45 / $2,326.00	Facility		$1,042.81	$1,337.45	$2,326.00
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $1,133.53 / $1,163.00 / $1,163.00	Facility		$1,133.53	$1,163.00	$1,163.00
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $946.08 / $1,012.27 / $1,310.00	Professional		$946.08	$1,012.27	$1,310.00
United Facility/Professional Facility Modifier Low / Median / High Price $595.23 / $595.23 / $595.23	Facility		$595.23	$595.23	$595.23
United Facility/Professional Professional Modifier Low / Median / High Price $545.71 / $822.02 / $1,041.13	Professional		$545.71	$822.02	$1,041.13
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $598.35 / $598.35 / $656.97	Professional		$598.35	$598.35	$656.97