Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $490.49 / $1,113.41 / $1,162.46	Facility		$490.49	$1,113.41	$1,162.46
Aetna Facility/Professional Professional Modifier Low / Median / High Price $418.55 / $586.95 / $767.39	Professional		$418.55	$586.95	$767.39
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $614.39 / $1,048.00 / $1,228.79	Professional		$614.39	$1,048.00	$1,228.79
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $541.80 / $1,059.54 / $3,006.95	Facility		$541.80	$1,059.54	$3,006.95
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $460.54 / $615.70 / $4,196.00	Professional		$460.54	$615.70	$4,196.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $621.29 / $647.80 / $647.80	Facility		$621.29	$647.80	$647.80
Cigna Facility/Professional Professional Modifier Low / Median / High Price $472.90 / $472.90 / $647.80	Professional		$472.90	$472.90	$647.80
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $530.16 / $1,197.72 / $2,781.15	Facility		$530.16	$1,197.72	$2,781.15
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $530.16 / $1,135.23 / $1,834.08	Professional		$530.16	$1,135.23	$1,834.08
Molina Facility/Professional Professional Modifier Low / Median / High Price $470.56 / $522.85 / $592.38	Professional		$470.56	$522.85	$592.38
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $558.05 / $568.54 / $819.19	Facility		$558.05	$568.54	$819.19
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $460.54 / $615.70 / $1,083.61	Facility		$460.54	$615.70	$1,083.61
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $460.54 / $615.70 / $790.74	Professional		$460.54	$615.70	$790.74
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $541.80 / $541.80 / $633.91	Facility		$541.80	$541.80	$633.91
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $445.89 / $474.35 / $615.70	Professional		$445.89	$474.35	$615.70
United Facility/Professional Professional Modifier Low / Median / High Price $440.21 / $535.96 / $765.65	Professional		$440.21	$535.96	$765.65
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $476.14 / $476.14 / $653.37	Professional		$476.14	$476.14	$653.37