Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,158.18 / $1,158.18 / $1,158.18	Facility		$1,158.18	$1,158.18	$1,158.18
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,052.89 / $1,084.47 / $1,158.18	Professional		$1,052.89	$1,084.47	$1,158.18
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $317.17 / $848.30 / $1,325.33	Facility		$317.17	$848.30	$1,325.33
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $368.15 / $1,052.89 / $1,529.24	Professional		$368.15	$1,052.89	$1,529.24
Cigna Facility/Professional Facility Modifier Low / Median / High Price $600.36 / $993.29 / $1,052.89	Facility		$600.36	$993.29	$1,052.89
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,052.89 / $1,052.89 / $1,291.28	Professional		$1,052.89	$1,052.89	$1,291.28
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,052.89 / $1,052.89 / $1,421.40	Facility		$1,052.89	$1,052.89	$1,421.40
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,052.89 / $1,052.89 / $1,316.11	Professional		$1,052.89	$1,052.89	$1,316.11
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 $300.18 / $1,052.89 / $1,989.96	Facility		$300.18	$1,052.89	$1,989.96
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $282.06 / $282.06 / $317.17	Facility		$282.06	$282.06	$317.17
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $317.17 / $325.67 / $551.65	Professional		$317.17	$325.67	$551.65
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $1,052.89 / $1,052.89 / $1,052.89	Facility		$1,052.89	$1,052.89	$1,052.89
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $1,000.25 / $1,052.89 / $1,052.89	Professional		$1,000.25	$1,052.89	$1,052.89
United Facility/Professional Professional Modifier Low / Median / High Price $1,052.89 / $1,052.89 / $1,263.47	Professional		$1,052.89	$1,052.89	$1,263.47
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $300.18 / $1,052.89 / $1,052.89	Professional		$300.18	$1,052.89	$1,052.89