Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $434.19 / $985.61 / $1,029.03	Facility		$434.19	$985.61	$1,029.03
Aetna Facility/Professional Professional Modifier Low / Median / High Price $334.07 / $434.19 / $1,029.03	Professional		$334.07	$434.19	$1,029.03
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $585.04 / $2,890.88 / $2,890.88	Facility		$585.04	$2,890.88	$2,890.88
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $467.69 / $734.94 / $4,893.53	Professional		$467.69	$734.94	$4,893.53
Cigna Facility/Professional Facility Modifier Low / Median / High Price $375.74 / $375.74 / $375.74	Facility		$375.74	$375.74	$375.74
Cigna Facility/Professional Professional Modifier Low / Median / High Price $319.38 / $319.38 / $375.74	Professional		$319.38	$319.38	$375.74
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $340.71 / $647.04 / $1,198.35	Facility		$340.71	$647.04	$1,198.35
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $378.52 / $668.13 / $1,276.83	Professional		$378.52	$668.13	$1,276.83
Molina Facility/Professional Professional Modifier Low / Median / High Price $60.00 / $668.13 / $668.13	Professional		$60.00	$668.13	$668.13
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $601.32 / $652.47 / $734.94	Facility		$601.32	$652.47	$734.94
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $530.76 / $530.76 / $530.76	Professional		$530.76	$530.76	$530.76
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $585.04 / $585.04 / $1,081.80	Facility		$585.04	$585.04	$1,081.80
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $487.73 / $734.94 / $734.94	Professional		$487.73	$734.94	$734.94
United Facility/Professional Professional Modifier Low / Median / High Price $299.99 / $451.88 / $572.35	Professional		$299.99	$451.88	$572.35
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $361.14 / $567.91 / $567.91	Professional		$361.14	$567.91	$567.91