Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $703.25 / $1,596.38 / $2,580.73	Facility		$703.25	$1,596.38	$2,580.73
Aetna Facility/Professional Professional Modifier Low / Median / High Price $535.21 / $703.25 / $1,216.61	Professional		$535.21	$703.25	$1,216.61
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $1,563.14 / $1,563.14 / $1,563.14	Professional		$1,563.14	$1,563.14	$1,563.14
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $912.49 / $2,291.83 / $5,530.59	Facility		$912.49	$2,291.83	$5,530.59
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $760.73 / $1,007.12 / $6,973.74	Professional		$760.73	$1,007.12	$6,973.74
Cigna Facility/Professional Facility Modifier Low / Median / High Price $700.00 / $700.00 / $773.33	Facility		$700.00	$700.00	$773.33
Cigna Facility/Professional Professional Modifier Low / Median / High Price $511.00 / $511.00 / $773.33	Professional		$511.00	$511.00	$773.33
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $646.54 / $1,101.15 / $2,855.58	Facility		$646.54	$1,101.15	$2,855.58
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $647.26 / $1,101.15 / $2,181.29	Professional		$647.26	$1,101.15	$2,181.29
Molina Facility/Professional Professional Modifier Low / Median / High Price $718.99 / $798.88 / $878.76	Professional		$718.99	$798.88	$878.76
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $827.19 / $1,017.67 / $1,158.28	Facility		$827.19	$1,017.67	$1,158.28
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $937.88 / $1,042.08 / $1,158.28	Professional		$937.88	$1,042.08	$1,158.28
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $912.49 / $1,170.32 / $2,035.34	Facility		$912.49	$1,170.32	$2,035.34
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $991.88 / $1,017.67 / $1,017.67	Facility		$991.88	$1,017.67	$1,017.67
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $827.85 / $885.78 / $1,146.30	Professional		$827.85	$885.78	$1,146.30
United Facility/Professional Facility Modifier Low / Median / High Price $480.00 / $480.00 / $480.00	Facility		$480.00	$480.00	$480.00
United Facility/Professional Professional Modifier Low / Median / High Price $474.02 / $513.53 / $978.15	Professional		$474.02	$513.53	$978.15
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $608.87 / $608.87 / $613.00	Professional		$608.87	$608.87	$613.00