Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $377.48 / $509.72 / $647.15	Facility		$377.48	$509.72	$647.15
Aetna Facility/Professional Professional Modifier Low / Median / High Price $220.77 / $301.33 / $639.84	Professional		$220.77	$301.33	$639.84
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $110.39 / $145.29 / $306.86	Professional	52	$110.39	$145.29	$306.86
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $267.41 / $289.82 / $771.00	Professional		$267.41	$289.82	$771.00
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $261.64 / $1,332.16 / $1,332.16	Facility		$261.64	$1,332.16	$1,332.16
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $309.60 / $597.32 / $2,440.80	Professional		$309.60	$597.32	$2,440.80
Cigna Facility/Professional Professional Modifier Low / Median / High Price $249.17 / $421.39 / $876.25	Professional		$249.17	$421.39	$876.25
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $221.34 / $399.60 / $591.69	Facility		$221.34	$399.60	$591.69
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $221.34 / $386.40 / $593.82	Professional		$221.34	$386.40	$593.82
Molina Facility/Professional Professional Modifier Low / Median / High Price $86.73 / $481.21 / $854.33	Professional		$86.73	$481.21	$854.33
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $329.28 / $479.60 / $584.24	Facility		$329.28	$479.60	$584.24
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $401.45 / $653.39 / $817.33	Professional		$401.45	$653.39	$817.33
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $400.09 / $562.90 / $717.95	Professional		$400.09	$562.90	$717.95
United Facility/Professional Professional Modifier Low / Median / High Price $228.38 / $363.30 / $745.97	Professional		$228.38	$363.30	$745.97
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $242.94 / $311.63 / $311.63	Professional		$242.94	$311.63	$311.63