Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $296.33 / $555.78 / $1,719.60	Facility		$296.33	$555.78	$1,719.60
Aetna Facility/Professional Professional Modifier Low / Median / High Price $313.69 / $321.26 / $555.78	Professional		$313.69	$321.26	$555.78
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $312.57 / $342.01 / $942.50	Professional		$312.57	$342.01	$942.50
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $359.05 / $817.60 / $2,285.06	Facility		$359.05	$817.60	$2,285.06
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $341.10 / $359.05 / $3,490.28	Professional		$341.10	$359.05	$3,490.28
Cigna Facility/Professional Professional Modifier Low / Median / High Price $321.14 / $321.14 / $630.42	Professional		$321.14	$321.14	$630.42
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $286.75 / $590.16 / $968.11	Facility		$286.75	$590.16	$968.11
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $286.75 / $605.00 / $1,005.10	Professional		$286.75	$605.00	$1,005.10
Molina Facility/Professional Professional Modifier Low / Median / High Price $75.00 / $75.00 / $394.95	Professional		$75.00	$75.00	$394.95
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $79,999.20 / $79,999.20 / $79,999.20	Facility		$79,999.20	$79,999.20	$79,999.20
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $359.05 / $359.05 / $359.05	Facility		$359.05	$359.05	$359.05
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $359.05 / $359.05 / $359.05	Professional		$359.05	$359.05	$359.05
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $359.05 / $359.05 / $359.05	Facility		$359.05	$359.05	$359.05
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $341.10 / $359.05 / $359.05	Professional		$341.10	$359.05	$359.05
United Facility/Professional Professional Modifier Low / Median / High Price $359.05 / $359.05 / $430.86	Professional		$359.05	$359.05	$430.86