Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $376.23 / $650.88 / $891.67	Facility		$376.23	$650.88	$891.67
Aetna Facility/Professional Professional Modifier Low / Median / High Price $351.46 / $376.23 / $988.59	Professional		$351.46	$376.23	$988.59
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $963.39 / $963.39 / $963.39	Professional		$963.39	$963.39	$963.39
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $520.75 / $520.75 / $2,474.44	Facility		$520.75	$520.75	$2,474.44
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $520.75 / $520.75 / $4,069.58	Professional		$520.75	$520.75	$4,069.58
Cigna Facility/Professional Facility Modifier Low / Median / High Price $440.51 / $440.51 / $768.84	Facility		$440.51	$440.51	$768.84
Cigna Facility/Professional Professional Modifier Low / Median / High Price $440.51 / $440.51 / $440.51	Professional		$440.51	$440.51	$440.51
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $473.63 / $996.82 / $1,581.56	Facility		$473.63	$996.82	$1,581.56
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $473.63 / $1,021.93 / $1,581.56	Professional		$473.63	$1,021.93	$1,581.56
Molina Facility/Professional Professional Modifier Low / Median / High Price $75.00 / $75.00 / $572.82	Professional		$75.00	$75.00	$572.82
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $520.75 / $520.75 / $936.66	Facility		$520.75	$520.75	$936.66
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $520.75 / $520.75 / $520.75	Facility		$520.75	$520.75	$520.75
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $520.75 / $520.75 / $520.75	Professional		$520.75	$520.75	$520.75
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $520.75 / $520.75 / $520.75	Facility		$520.75	$520.75	$520.75
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $494.71 / $520.75 / $520.75	Professional		$494.71	$520.75	$520.75
United Facility/Professional Professional Modifier Low / Median / High Price $520.75 / $520.75 / $624.90	Professional		$520.75	$520.75	$624.90