Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $360.06 / $817.34 / $853.34	Facility		$360.06	$817.34	$853.34
Aetna Facility/Professional Professional Modifier Low / Median / High Price $241.00 / $360.06 / $853.34	Professional		$241.00	$360.06	$853.34
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $485.15 / $1,055.08 / $2,633.25	Facility		$485.15	$1,055.08	$2,633.25
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $377.55 / $476.49 / $3,084.82	Professional		$377.55	$476.49	$3,084.82
Cigna Facility/Professional Facility Modifier Low / Median / High Price $365.10 / $365.10 / $365.10	Facility		$365.10	$365.10	$365.10
Cigna Facility/Professional Professional Modifier Low / Median / High Price $266.52 / $266.52 / $365.10	Professional		$266.52	$266.52	$365.10
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $303.48 / $554.05 / $1,380.93	Facility		$303.48	$554.05	$1,380.93
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $303.81 / $554.05 / $1,023.61	Professional		$303.81	$554.05	$1,023.61
Molina Facility/Professional Professional Modifier Low / Median / High Price $382.26 / $424.74 / $467.21	Professional		$382.26	$424.74	$467.21
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $439.79 / $498.65 / $554.05	Facility		$439.79	$498.65	$554.05
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $482.00 / $554.05 / $554.05	Professional		$482.00	$554.05	$554.05
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $485.15 / $622.23 / $1,082.14	Facility		$485.15	$622.23	$1,082.14
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $527.36 / $541.07 / $541.07	Facility		$527.36	$541.07	$541.07
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $440.14 / $470.95 / $609.47	Professional		$440.14	$470.95	$609.47
United Facility/Professional Professional Modifier Low / Median / High Price $240.46 / $360.69 / $458.78	Professional		$240.46	$360.69	$458.78
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $255.93 / $255.93 / $294.47	Professional		$255.93	$255.93	$294.47