Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $674.29 / $1,530.64 / $1,598.07	Facility		$674.29	$1,530.64	$1,598.07
Aetna Facility/Professional Professional Modifier Low / Median / High Price $539.15 / $674.29 / $1,598.07	Professional		$539.15	$674.29	$1,598.07
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $908.56 / $1,874.57 / $4,278.92	Facility		$908.56	$1,874.57	$4,278.92
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $605.52 / $881.96 / $5,369.93	Professional		$605.52	$881.96	$5,369.93
Cigna Facility/Professional Facility Modifier Low / Median / High Price $649.92 / $649.92 / $649.92	Facility		$649.92	$649.92	$649.92
Cigna Facility/Professional Professional Modifier Low / Median / High Price $474.45 / $474.45 / $649.92	Professional		$474.45	$474.45	$649.92
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $508.69 / $985.72 / $2,315.62	Facility		$508.69	$985.72	$2,315.62
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $509.24 / $985.72 / $1,716.23	Professional		$509.24	$985.72	$1,716.23
Molina Facility/Professional Professional Modifier Low / Median / High Price $715.88 / $795.43 / $874.97	Professional		$715.88	$795.43	$874.97
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $823.63 / $1,013.28 / $1,078.30	Facility		$823.63	$1,013.28	$1,078.30
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $823.63 / $1,037.59 / $1,078.30	Professional		$823.63	$1,037.59	$1,078.30
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $908.56 / $1,165.27 / $2,026.56	Facility		$908.56	$1,165.27	$2,026.56
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $987.60 / $1,013.28 / $1,013.28	Facility		$987.60	$1,013.28	$1,013.28
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $824.28 / $881.96 / $1,141.35	Professional		$824.28	$881.96	$1,141.35
United Facility/Professional Professional Modifier Low / Median / High Price $403.46 / $607.76 / $769.76	Professional		$403.46	$607.76	$769.76
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $427.77 / $427.77 / $881.96	Professional		$427.77	$427.77	$881.96