Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $638.30 / $1,462.42 / $7,184.76	Facility		$638.30	$1,462.42	$7,184.76
Aetna Facility/Professional Professional Modifier Low / Median / High Price $479.76 / $858.75 / $1,139.97	Professional		$479.76	$858.75	$1,139.97
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $407.43 / $407.43 / $407.43	Professional		$407.43	$407.43	$407.43
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $713.00 / $1,358.10 / $6,102.49	Facility		$713.00	$1,358.10	$6,102.49
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $410.82 / $1,199.39 / $6,454.55	Professional		$410.82	$1,199.39	$6,454.55
Cigna Facility/Professional Facility Modifier Low / Median / High Price $713.30 / $1,231.50 / $1,907.03	Facility		$713.30	$1,231.50	$1,907.03
Cigna Facility/Professional Professional Modifier Low / Median / High Price $423.83 / $790.19 / $1,498.36	Professional		$423.83	$790.19	$1,498.36
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $827.39 / $1,303.95 / $2,393.29	Facility		$827.39	$1,303.95	$2,393.29
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $840.13 / $1,303.95 / $2,208.59	Professional		$840.13	$1,303.95	$2,208.59
Molina Facility/Professional Professional Modifier Low / Median / High Price $75.00 / $75.00 / $75.00	Professional		$75.00	$75.00	$75.00
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $679.05 / $947.31 / $1,955.93	Facility		$679.05	$947.31	$1,955.93
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $679.05 / $1,018.57 / $1,867.39	Facility		$679.05	$1,018.57	$1,867.39
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $611.15 / $814.86 / $964.25	Professional		$611.15	$814.86	$964.25
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $713.00 / $1,114.32 / $2,071.10	Facility		$713.00	$1,114.32	$2,071.10
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $906.44 / $1,326.85 / $1,806.42	Professional		$906.44	$1,326.85	$1,806.42
United Facility/Professional Professional Modifier Low / Median / High Price $285.20 / $326.02 / $814.86	Professional		$285.20	$326.02	$814.86
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $351.75 / $351.75 / $586.78	Professional		$351.75	$351.75	$586.78