Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $442.13 / $880.00 / $1,516.79	Facility		$442.13	$880.00	$1,516.79
Aetna Facility/Professional Professional Modifier Low / Median / High Price $592.83 / $771.67 / $926.02	Professional		$592.83	$771.67	$926.02
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $1,150.00 / $1,150.00 / $1,150.00	Professional		$1,150.00	$1,150.00	$1,150.00
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $883.24 / $883.24 / $4,203.77	Facility		$883.24	$883.24	$4,203.77
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $883.24 / $883.24 / $6,913.58	Professional		$883.24	$883.24	$6,913.58
Cigna Facility/Professional Professional Modifier Low / Median / High Price $853.23 / $853.23 / $1,248.78	Professional		$853.23	$853.23	$1,248.78
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $753.92 / $1,774.98 / $2,180.77	Facility		$753.92	$1,774.98	$2,180.77
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $753.92 / $1,774.98 / $2,227.76	Professional		$753.92	$1,774.98	$2,227.76
Molina Facility/Professional Professional Modifier Low / Median / High Price $75.00 / $75.00 / $971.56	Professional		$75.00	$75.00	$971.56
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $883.24 / $883.24 / $1,591.25	Facility		$883.24	$883.24	$1,591.25
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $883.24 / $883.24 / $883.24	Facility		$883.24	$883.24	$883.24
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $883.24 / $883.24 / $883.24	Professional		$883.24	$883.24	$883.24
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $883.24 / $883.24 / $883.24	Facility		$883.24	$883.24	$883.24
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $839.08 / $883.24 / $883.24	Professional		$839.08	$883.24	$883.24
United Facility/Professional Professional Modifier Low / Median / High Price $883.24 / $883.24 / $1,059.89	Professional		$883.24	$883.24	$1,059.89