Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $242.00 / $593.29 / $1,408.39	Facility		$242.00	$593.29	$1,408.39
Aetna Facility/Professional Professional Modifier Low / Median / High Price $199.22 / $229.43 / $381.03	Professional		$199.22	$229.43	$381.03
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $154.47 / $154.47 / $154.47	Professional		$154.47	$154.47	$154.47
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $270.32 / $450.54 / $1,063.63	Facility		$270.32	$450.54	$1,063.63
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $231.71 / $546.90 / $1,930.88	Professional		$231.71	$546.90	$1,930.88
Cigna Facility/Professional Facility Modifier Low / Median / High Price $178.20 / $527.12 / $753.03	Facility		$178.20	$527.12	$753.03
Cigna Facility/Professional Professional Modifier Low / Median / High Price $160.69 / $288.58 / $378.25	Professional		$160.69	$288.58	$378.25
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $257.45 / $378.45 / $796.40	Facility		$257.45	$378.45	$796.40
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $257.45 / $454.71 / $796.40	Professional		$257.45	$454.71	$796.40
Molina Facility/Professional Professional Modifier Low / Median / High Price $75.00 / $252.04 / $273.19	Professional		$75.00	$252.04	$273.19
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $257.45 / $257.45 / $547.35	Facility		$257.45	$257.45	$547.35
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $257.45 / $450.54 / $772.35	Facility		$257.45	$450.54	$772.35
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $231.71 / $231.71 / $231.71	Professional		$231.71	$231.71	$231.71
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $270.32 / $424.79 / $707.99	Facility		$270.32	$424.79	$707.99
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $300.18 / $501.05 / $598.29	Professional		$300.18	$501.05	$598.29
United Facility/Professional Professional Modifier Low / Median / High Price $108.13 / $147.15 / $288.33	Professional		$108.13	$147.15	$288.33