Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,006.60 / $1,006.60 / $1,006.60	Facility		$1,006.60	$1,006.60	$1,006.60
Aetna Facility/Professional Professional Modifier Low / Median / High Price $915.09 / $942.54 / $1,006.60	Professional		$915.09	$942.54	$1,006.60
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $915.09 / $1,417.80 / $2,153.31	Facility		$915.09	$1,417.80	$2,153.31
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $736.18 / $915.09 / $3,800.00	Professional		$736.18	$915.09	$3,800.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $863.29 / $863.29 / $989.88	Facility		$863.29	$863.29	$989.88
Cigna Facility/Professional Professional Modifier Low / Median / High Price $915.09 / $915.09 / $1,122.28	Professional		$915.09	$915.09	$1,122.28
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $915.09 / $915.09 / $1,235.36	Facility		$915.09	$915.09	$1,235.36
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $915.09 / $915.09 / $1,235.36	Professional		$915.09	$915.09	$1,235.36
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 $528.01 / $915.09 / $1,729.52	Facility		$528.01	$915.09	$1,729.52
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $736.18 / $1,384.44 / $1,384.44	Facility		$736.18	$1,384.44	$1,384.44
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $529.13 / $598.14 / $943.23	Professional		$529.13	$598.14	$943.23
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $915.09 / $915.09 / $915.09	Facility		$915.09	$915.09	$915.09
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $869.34 / $915.09 / $915.09	Professional		$869.34	$915.09	$915.09
United Facility/Professional Professional Modifier Low / Median / High Price $915.09 / $915.09 / $1,098.10	Professional		$915.09	$915.09	$1,098.10
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $487.72 / $915.09 / $915.09	Professional		$487.72	$915.09	$915.09