Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $556.62 / $1,263.53 / $1,319.19	Facility		$556.62	$1,263.53	$1,319.19
Aetna Facility/Professional Professional Modifier Low / Median / High Price $443.58 / $556.62 / $1,319.19	Professional		$443.58	$556.62	$1,319.19
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $750.00 / $1,631.08 / $4,086.48	Facility		$750.00	$1,631.08	$4,086.48
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $609.92 / $745.17 / $4,418.01	Professional		$609.92	$745.17	$4,418.01
Cigna Facility/Professional Facility Modifier Low / Median / High Price $624.54 / $624.54 / $624.54	Facility		$624.54	$624.54	$624.54
Cigna Facility/Professional Professional Modifier Low / Median / High Price $455.91 / $455.91 / $624.54	Professional		$455.91	$455.91	$624.54
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $520.32 / $888.55 / $2,347.10	Facility		$520.32	$888.55	$2,347.10
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $549.63 / $902.81 / $1,663.27	Professional		$549.63	$902.81	$1,663.27
Molina Facility/Professional Professional Modifier Low / Median / High Price $590.95 / $656.62 / $722.28	Professional		$590.95	$656.62	$722.28
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $679.89 / $836.45 / $887.15	Facility		$679.89	$836.45	$887.15
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $856.52 / $856.52 / $887.15	Professional		$856.52	$856.52	$887.15
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $750.00 / $961.92 / $1,672.90	Facility		$750.00	$961.92	$1,672.90
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $815.25 / $836.45 / $836.45	Facility		$815.25	$836.45	$836.45
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $680.44 / $728.04 / $942.17	Professional		$680.44	$728.04	$942.17
United Facility/Professional Professional Modifier Low / Median / High Price $391.10 / $561.07 / $746.16	Professional		$391.10	$561.07	$746.16
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $476.72 / $728.04 / $728.04	Professional		$476.72	$728.04	$728.04