Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $799.16 / $1,814.09 / $1,894.01	Facility		$799.16	$1,814.09	$1,894.01
Aetna Facility/Professional Professional Modifier Low / Median / High Price $578.54 / $799.16 / $1,894.01	Professional		$578.54	$799.16	$1,894.01
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $1,076.81 / $2,345.71 / $6,077.59	Facility		$1,076.81	$2,345.71	$6,077.59
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $867.81 / $1,069.86 / $7,636.71	Professional		$867.81	$1,069.86	$7,636.71
Cigna Facility/Professional Facility Modifier Low / Median / High Price $930.44 / $930.44 / $930.44	Facility		$930.44	$930.44	$930.44
Cigna Facility/Professional Professional Modifier Low / Median / High Price $679.22 / $679.22 / $930.44	Professional		$679.22	$679.22	$930.44
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $728.00 / $1,239.54 / $3,313.12	Facility		$728.00	$1,239.54	$3,313.12
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $728.80 / $1,254.33 / $2,455.19	Professional		$728.80	$1,254.33	$2,455.19
Molina Facility/Professional Professional Modifier Low / Median / High Price $848.46 / $942.74 / $1,037.01	Professional		$848.46	$942.74	$1,037.01
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $976.15 / $1,157.08 / $1,229.74	Facility		$976.15	$1,157.08	$1,229.74
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $1,157.08 / $1,229.74 / $1,229.74	Professional		$1,157.08	$1,229.74	$1,229.74
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,076.81 / $1,381.06 / $2,401.84	Facility		$1,076.81	$1,381.06	$2,401.84
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $1,170.49 / $1,200.92 / $1,200.92	Facility		$1,170.49	$1,200.92	$1,200.92
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $976.93 / $1,045.28 / $1,352.71	Professional		$976.93	$1,045.28	$1,352.71
United Facility/Professional Professional Modifier Low / Median / High Price $577.25 / $828.15 / $1,101.33	Professional		$577.25	$828.15	$1,101.33
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $699.29 / $1,284.35 / $1,284.35	Professional		$699.29	$1,284.35	$1,284.35