Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $808.55 / $808.55 / $808.55	Facility		$808.55	$808.55	$808.55
Aetna Facility/Professional Professional Modifier Low / Median / High Price $735.05 / $808.55 / $882.05	Professional		$735.05	$808.55	$882.05
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $735.05 / $1,887.00 / $4,440.00	Facility		$735.05	$1,887.00	$4,440.00
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $735.05 / $764.45 / $8,880.00	Professional		$735.05	$764.45	$8,880.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $693.44 / $693.44 / $1,870.04	Facility		$693.44	$693.44	$1,870.04
Cigna Facility/Professional Professional Modifier Low / Median / High Price $735.05 / $735.05 / $901.47	Professional		$735.05	$735.05	$901.47
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $735.05 / $735.05 / $992.32	Facility		$735.05	$735.05	$992.32
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $735.05 / $735.05 / $992.32	Professional		$735.05	$735.05	$992.32
Molina Facility/Professional Professional Modifier Low / Median / High Price $30.00 / $60.00 / $60.00	Professional		$30.00	$60.00	$60.00
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $735.05 / $813.21 / $1,528.90	Facility		$735.05	$813.21	$1,528.90
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,468.43 / $1,842.60 / $1,842.60	Facility		$1,468.43	$1,842.60	$1,842.60
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,055.44 / $1,193.09 / $1,881.43	Professional		$1,055.44	$1,193.09	$1,881.43
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $735.05 / $735.05 / $735.05	Facility		$735.05	$735.05	$735.05
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $698.30 / $735.05 / $735.05	Professional		$698.30	$735.05	$735.05
United Facility/Professional Professional Modifier Low / Median / High Price $735.05 / $735.05 / $882.06	Professional		$735.05	$735.05	$882.06
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $735.05 / $735.05 / $735.05	Professional		$735.05	$735.05	$735.05