Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $125.40 / $315.33 / $646.32	Facility		$125.40	$315.33	$646.32
Aetna Facility/Professional Professional Modifier Low / Median / High Price $259.88 / $272.70 / $364.06	Professional		$259.88	$272.70	$364.06
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $5.83 / $192.50 / $400.00	Professional		$5.83	$192.50	$400.00
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $122.72 / $304.80 / $1,203.15	Facility		$122.72	$304.80	$1,203.15
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $304.80 / $304.80 / $1,443.78	Professional		$304.80	$304.80	$1,443.78
Cigna Facility/Professional Facility Modifier Low / Median / High Price $272.70 / $272.70 / $545.41	Facility		$272.70	$272.70	$545.41
Cigna Facility/Professional Professional Modifier Low / Median / High Price $272.70 / $272.70 / $272.70	Professional		$272.70	$272.70	$272.70
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $68.31 / $143.41 / $770.12	Facility		$68.31	$143.41	$770.12
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $68.31 / $150.60 / $871.22	Professional		$68.31	$150.60	$871.22
Molina Facility/Professional Professional Modifier Low / Median / High Price $75.00 / $75.00 / $335.28	Professional		$75.00	$75.00	$335.28
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $304.80 / $304.80 / $790.60	Facility		$304.80	$304.80	$790.60
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $304.80 / $304.80 / $304.80	Facility		$304.80	$304.80	$304.80
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $304.80 / $304.80 / $304.80	Professional		$304.80	$304.80	$304.80
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $304.80 / $304.80 / $304.80	Facility		$304.80	$304.80	$304.80
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $289.56 / $304.80 / $304.80	Professional		$289.56	$304.80	$304.80
United Facility/Professional Professional Modifier Low / Median / High Price $267.37 / $267.37 / $320.83	Professional		$267.37	$267.37	$320.83