Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $507.49 / $507.49 / $507.49	Facility		$507.49	$507.49	$507.49
Aetna Facility/Professional Professional Modifier Low / Median / High Price $461.36 / $475.20 / $507.49	Professional		$461.36	$475.20	$507.49
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $1,384.44 / $1,417.80 / $3,171.34	Facility		$1,384.44	$1,417.80	$3,171.34
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $500.53 / $3,610.00 / $3,975.44	Professional		$500.53	$3,610.00	$3,975.44
Cigna Facility/Professional Facility Modifier Low / Median / High Price $435.24 / $435.24 / $1,003.10	Facility		$435.24	$435.24	$1,003.10
Cigna Facility/Professional Professional Modifier Low / Median / High Price $461.36 / $461.36 / $565.80	Professional		$461.36	$461.36	$565.80
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $461.36 / $461.36 / $622.84	Facility		$461.36	$461.36	$622.84
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $461.36 / $461.36 / $622.84	Professional		$461.36	$461.36	$622.84
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $75.00 / $75.00	Professional		$50.00	$75.00	$75.00
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $330.31 / $461.36 / $957.53	Facility		$330.31	$461.36	$957.53
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $786.46 / $1,384.44 / $1,384.44	Facility		$786.46	$1,384.44	$1,384.44
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $565.26 / $638.99 / $1,007.64	Professional		$565.26	$638.99	$1,007.64
United Facility/Professional Professional Modifier Low / Median / High Price $461.36 / $461.36 / $553.63	Professional		$461.36	$461.36	$553.63
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $461.36 / $461.36 / $521.03	Professional		$461.36	$461.36	$521.03