Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $413.85 / $939.44 / $980.82	Facility		$413.85	$939.44	$980.82
Aetna Facility/Professional Professional Modifier Low / Median / High Price $387.32 / $413.85 / $980.82	Professional		$387.32	$413.85	$980.82
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $557.64 / $1,273.68 / $3,385.23	Facility		$557.64	$1,273.68	$3,385.23
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $464.89 / $557.30 / $4,203.14	Professional		$464.89	$557.30	$4,203.14
Cigna Facility/Professional Facility Modifier Low / Median / High Price $397.94 / $397.94 / $397.94	Facility		$397.94	$397.94	$397.94
Cigna Facility/Professional Professional Modifier Low / Median / High Price $290.50 / $290.50 / $397.94	Professional		$290.50	$290.50	$397.94
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $400.85 / $677.48 / $1,745.10	Facility		$400.85	$677.48	$1,745.10
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $401.29 / $681.79 / $1,351.30	Professional		$401.29	$681.79	$1,351.30
Molina Facility/Professional Professional Modifier Low / Median / High Price $439.38 / $488.20 / $537.02	Professional		$439.38	$488.20	$537.02
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $505.50 / $621.91 / $843.27	Facility		$505.50	$621.91	$843.27
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $573.16 / $636.84 / $843.27	Professional		$573.16	$636.84	$843.27
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $557.64 / $715.21 / $1,243.83	Facility		$557.64	$715.21	$1,243.83
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $606.16 / $621.91 / $621.91	Facility		$606.16	$621.91	$621.91
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $505.91 / $541.30 / $700.52	Professional		$505.91	$541.30	$700.52
United Facility/Professional Professional Modifier Low / Median / High Price $317.70 / $476.57 / $606.16	Professional		$317.70	$476.57	$606.16
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $189.95 / $189.95 / $386.54	Professional		$189.95	$189.95	$386.54