Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $841.44 / $1,910.07 / $1,994.21	Facility		$841.44	$1,910.07	$1,994.21
Aetna Facility/Professional Professional Modifier Low / Median / High Price $647.41 / $841.44 / $1,994.21	Professional		$647.41	$841.44	$1,994.21
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $1,133.79 / $2,589.65 / $5,928.30	Facility		$1,133.79	$2,589.65	$5,928.30
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $945.22 / $1,370.91 / $12,644.70	Professional		$945.22	$1,370.91	$12,644.70
Cigna Facility/Professional Facility Modifier Low / Median / High Price $809.08 / $809.08 / $809.08	Facility		$809.08	$809.08	$809.08
Cigna Facility/Professional Professional Modifier Low / Median / High Price $687.72 / $687.72 / $809.08	Professional		$687.72	$687.72	$809.08
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $859.20 / $1,467.26 / $3,650.46	Facility		$859.20	$1,467.26	$3,650.46
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $907.99 / $1,489.04 / $2,747.30	Professional		$907.99	$1,489.04	$2,747.30
Molina Facility/Professional Professional Modifier Low / Median / High Price $60.00 / $60.00 / $1,294.82	Professional		$60.00	$60.00	$1,294.82
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,165.33 / $1,264.47 / $1,424.30	Facility		$1,165.33	$1,264.47	$1,424.30
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $1,028.61 / $1,028.61 / $1,028.61	Professional		$1,028.61	$1,028.61	$1,028.61
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,133.79 / $1,454.14 / $2,528.94	Facility		$1,133.79	$1,454.14	$2,528.94
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $1,232.43 / $1,264.47 / $1,264.47	Facility		$1,232.43	$1,264.47	$1,264.47
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $945.22 / $1,424.30 / $1,424.30	Professional		$945.22	$1,424.30	$1,424.30
United Facility/Professional Professional Modifier Low / Median / High Price $645.97 / $968.96 / $1,232.43	Professional		$645.97	$968.96	$1,232.43
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,084.80 / $1,100.59 / $1,100.59	Professional		$1,084.80	$1,100.59	$1,100.59