Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $465.58 / $1,056.86 / $1,103.42	Facility		$465.58	$1,056.86	$1,103.42
Aetna Facility/Professional Professional Modifier Low / Median / High Price $378.90 / $465.58 / $1,103.42	Professional		$378.90	$465.58	$1,103.42
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $627.34 / $1,364.32 / $3,490.81	Facility		$627.34	$1,364.32	$3,490.81
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $520.23 / $627.34 / $3,773.79	Professional		$520.23	$627.34	$3,773.79
Cigna Facility/Professional Facility Modifier Low / Median / High Price $564.36 / $564.36 / $564.36	Facility		$564.36	$564.36	$564.36
Cigna Facility/Professional Professional Modifier Low / Median / High Price $411.98 / $411.98 / $564.36	Professional		$411.98	$411.98	$564.36
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $443.52 / $757.40 / $1,963.26	Facility		$443.52	$757.40	$1,963.26
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $468.41 / $769.40 / $1,417.50	Professional		$468.41	$769.40	$1,417.50
Molina Facility/Professional Professional Modifier Low / Median / High Price $494.31 / $549.24 / $604.16	Professional		$494.31	$549.24	$604.16
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $644.79 / $716.44 / $757.79	Facility		$644.79	$716.44	$757.79
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $569.16 / $569.16 / $569.16	Professional		$569.16	$569.16	$569.16
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $627.34 / $804.60 / $1,399.30	Facility		$627.34	$804.60	$1,399.30
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $681.92 / $699.65 / $699.65	Facility		$681.92	$699.65	$699.65
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $569.16 / $608.97 / $788.08	Professional		$569.16	$608.97	$788.08
United Facility/Professional Professional Modifier Low / Median / High Price $333.42 / $502.37 / $636.13	Professional		$333.42	$502.37	$636.13
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $424.98 / $608.97 / $608.97	Professional		$424.98	$608.97	$608.97