Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $699.20 / $1,587.18 / $1,657.10	Facility		$699.20	$1,587.18	$1,657.10
Aetna Facility/Professional Professional Modifier Low / Median / High Price $485.12 / $699.20 / $1,657.10	Professional		$485.12	$699.20	$1,657.10
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $942.13 / $1,943.85 / $4,826.53	Facility		$942.13	$1,943.85	$4,826.53
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $715.04 / $936.08 / $6,163.10	Professional		$715.04	$936.08	$6,163.10
Cigna Facility/Professional Facility Modifier Low / Median / High Price $583.49 / $583.49 / $583.49	Facility		$583.49	$583.49	$583.49
Cigna Facility/Professional Professional Modifier Low / Median / High Price $425.95 / $425.95 / $583.49	Professional		$425.95	$425.95	$583.49
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $587.40 / $1,075.95 / $2,673.75	Facility		$587.40	$1,075.95	$2,673.75
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $588.04 / $1,075.43 / $1,981.03	Professional		$588.04	$1,075.43	$1,981.03
Molina Facility/Professional Professional Modifier Low / Median / High Price $742.33 / $824.82 / $907.30	Professional		$742.33	$824.82	$907.30
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $854.05 / $970.24 / $1,075.95	Facility		$854.05	$970.24	$1,075.95
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $968.36 / $1,067.26 / $1,075.95	Professional		$968.36	$1,067.26	$1,075.95
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $942.13 / $1,208.33 / $2,101.46	Facility		$942.13	$1,208.33	$2,101.46
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $1,024.09 / $1,050.73 / $1,050.73	Facility		$1,024.09	$1,050.73	$1,050.73
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $854.74 / $914.56 / $1,183.55	Professional		$854.74	$914.56	$1,183.55
United Facility/Professional Facility Modifier Low / Median / High Price $466.72 / $466.72 / $466.72	Facility		$466.72	$466.72	$466.72
United Facility/Professional Professional Modifier Low / Median / High Price $465.86 / $701.76 / $888.80	Professional		$465.86	$701.76	$888.80
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $566.70 / $618.63 / $618.63	Professional		$566.70	$618.63	$618.63