Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $671.88 / $677.40 / $1,061.46	Professional		$671.88	$677.40	$1,061.46
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $3,076.50 / $3,076.50 / $3,076.50	Professional		$3,076.50	$3,076.50	$3,076.50
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $7,110.09 / $7,110.09	Facility		$100.00	$7,110.09	$7,110.09
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $1,000.00 / $1,129.13 / $1,505.50	Professional		$1,000.00	$1,129.13	$1,505.50
Cigna Facility/Professional Facility Modifier Low / Median / High Price $795.00 / $795.00 / $810.90	Facility		$795.00	$795.00	$810.90
Cigna Facility/Professional Professional Modifier Low / Median / High Price $675.75 / $795.00 / $1,107.00	Professional		$675.75	$795.00	$1,107.00
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,354.80 / $1,354.80 / $1,354.80	Facility		$1,354.80	$1,354.80	$1,354.80
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,354.80 / $1,354.80 / $1,354.80	Professional		$1,354.80	$1,354.80	$1,354.80
Molina Facility/Professional Professional Modifier Low / Median / High Price $824.98 / $824.98 / $1,008.31	Professional		$824.98	$824.98	$1,008.31
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $980.75 / $2,443.78 / $2,691.39	Facility		$980.75	$2,443.78	$2,691.39
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $2,209.35 / $2,653.71 / $2,691.39	Professional		$2,209.35	$2,653.71	$2,691.39
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $117.94 / $117.94 / $117.94	Facility		$117.94	$117.94	$117.94
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $151.27 / $1,349.88 / $1,512.71	Professional		$151.27	$1,349.88	$1,512.71
United Facility/Professional Professional Modifier Low / Median / High Price $484.44 / $668.58 / $1,285.59	Professional		$484.44	$668.58	$1,285.59