Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $474.24 / $474.24 / $474.24	Facility		$474.24	$474.24	$474.24
Aetna Facility/Professional Professional Modifier Low / Median / High Price $373.75 / $474.24 / $718.29	Professional		$373.75	$474.24	$718.29
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $622.13 / $622.13 / $622.13	Professional		$622.13	$622.13	$622.13
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $3,720.55 / $3,720.55	Facility		$100.00	$3,720.55	$3,720.55
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $111.36 / $581.30 / $1,108.71	Professional		$111.36	$581.30	$1,108.71
Cigna Facility/Professional Facility Modifier Low / Median / High Price $568.02 / $568.02 / $695.55	Facility		$568.02	$568.02	$695.55
Cigna Facility/Professional Professional Modifier Low / Median / High Price $482.82 / $568.02 / $695.55	Professional		$482.82	$568.02	$695.55
Molina Facility/Professional Professional Modifier Low / Median / High Price $60.00 / $72.69 / $72.69	Professional		$60.00	$72.69	$72.69
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,156.09 / $1,309.01 / $1,408.34	Facility		$1,156.09	$1,309.01	$1,408.34
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $1,156.09 / $1,388.62 / $1,408.34	Professional		$1,156.09	$1,388.62	$1,408.34
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $83.20 / $83.20 / $83.20	Facility		$83.20	$83.20	$83.20
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $59.99 / $811.67 / $951.62	Professional		$59.99	$811.67	$951.62
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $111.36 / $111.36 / $135.59	Professional		$111.36	$111.36	$135.59
United Facility/Professional Professional Modifier Low / Median / High Price $511.68 / $596.96 / $852.80	Professional		$511.68	$596.96	$852.80