Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $749.03 / $1,700.30 / $1,775.20	Facility		$749.03	$1,700.30	$1,775.20
Aetna Facility/Professional Professional Modifier Low / Median / High Price $701.02 / $749.03 / $1,775.20	Professional		$701.02	$749.03	$1,775.20
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $1,009.27 / $2,598.40 / $6,156.07	Facility		$1,009.27	$2,598.40	$6,156.07
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $841.41 / $1,152.61 / $8,214.44	Professional		$841.41	$1,152.61	$8,214.44
Cigna Facility/Professional Facility Modifier Low / Median / High Price $812.21 / $812.21 / $812.21	Facility		$812.21	$812.21	$812.21
Cigna Facility/Professional Professional Modifier Low / Median / High Price $592.91 / $592.91 / $812.21	Professional		$592.91	$592.91	$812.21
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $725.27 / $1,225.78 / $3,158.45	Facility		$725.27	$1,225.78	$3,158.45
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $726.06 / $1,234.47 / $2,446.09	Professional		$726.06	$1,234.47	$2,446.09
Molina Facility/Professional Professional Modifier Low / Median / High Price $795.24 / $883.61 / $971.97	Professional		$795.24	$883.61	$971.97
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $914.93 / $1,125.60 / $1,536.83	Facility		$914.93	$1,125.60	$1,536.83
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $1,037.35 / $1,152.61 / $1,536.83	Professional		$1,037.35	$1,152.61	$1,536.83
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,009.27 / $1,294.45 / $2,251.21	Facility		$1,009.27	$1,294.45	$2,251.21
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $1,097.08 / $1,125.60 / $1,125.60	Facility		$1,097.08	$1,125.60	$1,125.60
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $915.66 / $979.73 / $1,267.88	Professional		$915.66	$979.73	$1,267.88
United Facility/Professional Professional Modifier Low / Median / High Price $575.03 / $862.54 / $1,097.08	Professional		$575.03	$862.54	$1,097.08
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $427.77 / $427.77 / $704.17	Professional		$427.77	$427.77	$704.17