Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $558.71 / $979.00 / $1,324.14	Facility		$558.71	$979.00	$1,324.14
Aetna Facility/Professional Professional Modifier Low / Median / High Price $454.70 / $558.71 / $1,324.14	Professional		$454.70	$558.71	$1,324.14
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $752.83 / $1,637.24 / $4,189.10	Facility		$752.83	$1,637.24	$4,189.10
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $624.30 / $752.83 / $4,528.81	Professional		$624.30	$752.83	$4,528.81
Cigna Facility/Professional Facility Modifier Low / Median / High Price $528.74 / $528.74 / $528.74	Facility		$528.74	$528.74	$528.74
Cigna Facility/Professional Professional Modifier Low / Median / High Price $385.98 / $385.98 / $528.74	Professional		$385.98	$385.98	$528.74
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $532.32 / $909.04 / $2,355.92	Facility		$532.32	$909.04	$2,355.92
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $562.65 / $924.19 / $1,702.16	Professional		$562.65	$924.19	$1,702.16
Molina Facility/Professional Professional Modifier Low / Median / High Price $593.18 / $659.09 / $724.99	Professional		$593.18	$659.09	$724.99
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $773.78 / $859.76 / $909.40	Facility		$773.78	$859.76	$909.40
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $682.99 / $682.99 / $682.99	Professional		$682.99	$682.99	$682.99
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $752.83 / $965.55 / $1,679.22	Facility		$752.83	$965.55	$1,679.22
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $818.33 / $839.61 / $839.61	Facility		$818.33	$839.61	$839.61
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $682.99 / $730.80 / $945.74	Professional		$682.99	$730.80	$945.74
United Facility/Professional Professional Modifier Low / Median / High Price $400.12 / $600.17 / $763.37	Professional		$400.12	$600.17	$763.37
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $510.00 / $730.80 / $730.80	Professional		$510.00	$730.80	$730.80