Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $83.33 / $196.73 / $1,187.30	Facility		$83.33	$196.73	$1,187.30
Aetna Facility/Professional Professional Modifier Low / Median / High Price $438.73 / $615.59 / $904.86	Professional		$438.73	$615.59	$904.86
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $1,157.00 / $1,157.00 / $1,157.00	Professional		$1,157.00	$1,157.00	$1,157.00
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $567.94 / $1,110.64 / $3,153.85	Facility		$567.94	$1,110.64	$3,153.85
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $482.75 / $653.13 / $4,494.50	Professional		$482.75	$653.13	$4,494.50
Cigna Facility/Professional Facility Modifier Low / Median / High Price $636.97 / $636.97 / $712.60	Facility		$636.97	$636.97	$712.60
Cigna Facility/Professional Professional Modifier Low / Median / High Price $464.99 / $464.99 / $712.60	Professional		$464.99	$464.99	$712.60
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $555.73 / $1,256.36 / $3,068.66	Facility		$555.73	$1,256.36	$3,068.66
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $555.73 / $1,190.82 / $1,923.89	Professional		$555.73	$1,190.82	$1,923.89
Molina Facility/Professional Professional Modifier Low / Median / High Price $493.25 / $548.05 / $620.96	Professional		$493.25	$548.05	$620.96
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $584.98 / $595.98 / $885.07	Facility		$584.98	$595.98	$885.07
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $482.75 / $656.94 / $1,135.88	Facility		$482.75	$656.94	$1,135.88
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $482.75 / $653.13 / $862.30	Professional		$482.75	$653.13	$862.30
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $567.94 / $567.94 / $677.04	Facility		$567.94	$567.94	$677.04
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $467.40 / $497.23 / $656.94	Professional		$467.40	$497.23	$656.94
United Facility/Professional Professional Modifier Low / Median / High Price $461.69 / $500.17 / $803.01	Professional		$461.69	$500.17	$803.01
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $286.52 / $286.52 / $685.32	Professional		$286.52	$286.52	$685.32