Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $720.83 / $720.83 / $720.83	Facility		$720.83	$720.83	$720.83
Aetna Facility/Professional Professional Modifier Low / Median / High Price $655.29 / $720.83 / $786.36	Professional		$655.29	$720.83	$786.36
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $655.29 / $1,537.00 / $5,146.99	Facility		$655.29	$1,537.00	$5,146.99
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $655.29 / $705.84 / $5,800.00	Professional		$655.29	$705.84	$5,800.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $618.21 / $618.21 / $1,880.30	Facility		$618.21	$618.21	$1,880.30
Cigna Facility/Professional Professional Modifier Low / Median / High Price $655.29 / $655.29 / $803.67	Professional		$655.29	$655.29	$803.67
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $655.29 / $655.29 / $884.66	Facility		$655.29	$655.29	$884.66
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $655.29 / $655.29 / $884.66	Professional		$655.29	$655.29	$884.66
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 $655.29 / $730.43 / $1,454.88	Facility		$655.29	$730.43	$1,454.88
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,198.48 / $1,452.50 / $1,452.50	Facility		$1,198.48	$1,452.50	$1,452.50
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,102.60 / $1,198.48 / $1,867.72	Professional		$1,102.60	$1,198.48	$1,867.72
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $655.29 / $655.29 / $655.29	Facility		$655.29	$655.29	$655.29
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $622.54 / $655.29 / $655.29	Professional		$622.54	$655.29	$655.29
United Facility/Professional Professional Modifier Low / Median / High Price $655.29 / $655.29 / $786.36	Professional		$655.29	$655.29	$786.36
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $655.29 / $655.29 / $1,016.31	Professional		$655.29	$655.29	$1,016.31