Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $454.67 / $847.03 / $19,900.00	Facility		$454.67	$847.03	$19,900.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $384.16 / $562.94 / $861.95	Professional		$384.16	$562.94	$861.95
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $324.66 / $324.66 / $324.66	Professional		$324.66	$324.66	$324.66
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $403.99 / $1,710.73 / $9,102.00	Facility		$403.99	$1,710.73	$9,102.00
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $403.99 / $678.99 / $4,446.43	Professional		$403.99	$678.99	$4,446.43
Cigna Facility/Professional Facility Modifier Low / Median / High Price $393.81 / $393.81 / $479.00	Facility		$393.81	$393.81	$479.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $323.57 / $534.44 / $935.30	Professional		$323.57	$534.44	$935.30
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $200.90 / $692.95 / $1,503.39	Facility		$200.90	$692.95	$1,503.39
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $202.16 / $678.90 / $1,104.19	Professional		$202.16	$678.90	$1,104.19
Molina Facility/Professional Professional Modifier Low / Median / High Price $37.16 / $239.35 / $611.53	Professional		$37.16	$239.35	$611.53
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $470.34 / $578.32 / $1,330.96	Facility		$470.34	$578.32	$1,330.96
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $237.85 / $390.03 / $403.99	Facility		$237.85	$390.03	$403.99
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $403.99 / $625.96 / $765.77	Professional		$403.99	$625.96	$765.77
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $1,195.59 / $1,646.32 / $3,151.02	Facility		$1,195.59	$1,646.32	$3,151.02
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $366.83 / $566.47 / $838.65	Professional		$366.83	$566.47	$838.65
United Facility/Professional Facility Modifier Low / Median / High Price $332.00 / $648.00 / $4,611.00	Facility		$332.00	$648.00	$4,611.00
United Facility/Professional Professional Modifier Low / Median / High Price $381.99 / $648.80 / $920.45	Professional		$381.99	$648.80	$920.45