Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $721.74 / $721.74 / $721.74	Facility		$721.74	$721.74	$721.74
Aetna Facility/Professional Professional Modifier Low / Median / High Price $656.12 / $721.74 / $787.35	Professional		$656.12	$721.74	$787.35
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $656.12 / $1,417.80 / $2,502.00	Facility		$656.12	$1,417.80	$2,502.00
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $613.48 / $656.12 / $5,838.00	Professional		$613.48	$656.12	$5,838.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $618.98 / $618.98 / $2,060.28	Facility		$618.98	$618.98	$2,060.28
Cigna Facility/Professional Professional Modifier Low / Median / High Price $656.12 / $656.12 / $804.68	Professional		$656.12	$656.12	$804.68
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $656.12 / $656.12 / $885.76	Facility		$656.12	$656.12	$885.76
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $656.12 / $656.12 / $820.15	Professional		$656.12	$656.12	$820.15
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $50.00 / $75.00	Professional		$50.00	$50.00	$75.00
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $393.38 / $656.12 / $1,364.73	Facility		$393.38	$656.12	$1,364.73
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,384.44 / $1,384.44 / $1,417.80	Facility		$1,384.44	$1,384.44	$1,417.80
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,284.35 / $1,417.80 / $1,501.20	Professional		$1,284.35	$1,417.80	$1,501.20
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $656.12 / $656.12 / $656.12	Facility		$656.12	$656.12	$656.12
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $623.30 / $656.12 / $656.12	Professional		$623.30	$656.12	$656.12
United Facility/Professional Professional Modifier Low / Median / High Price $656.12 / $656.12 / $787.34	Professional		$656.12	$656.12	$787.34
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $254.99 / $656.12 / $656.12	Professional		$254.99	$656.12	$656.12