Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $582.66 / $916.88 / $3,640.56	Facility		$582.66	$916.88	$3,640.56
Aetna Facility/Professional Professional Modifier Low / Median / High Price $312.00 / $403.91 / $631.16	Professional		$312.00	$403.91	$631.16
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $448.90 / $448.90 / $598.53	Professional		$448.90	$448.90	$598.53
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $524.09 / $1,191.08 / $3,004.61	Facility		$524.09	$1,191.08	$3,004.61
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $432.48 / $544.10 / $3,565.78	Professional		$432.48	$544.10	$3,565.78
Cigna Facility/Professional Facility Modifier Low / Median / High Price $372.88 / $372.88 / $372.88	Facility		$372.88	$372.88	$372.88
Cigna Facility/Professional Professional Modifier Low / Median / High Price $272.20 / $272.20 / $372.88	Professional		$272.20	$272.20	$372.88
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $350.35 / $598.53 / $1,595.62	Facility		$350.35	$598.53	$1,595.62
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $350.73 / $610.50 / $1,182.49	Professional		$350.73	$610.50	$1,182.49
Molina Facility/Professional Professional Modifier Low / Median / High Price $412.94 / $458.83 / $504.71	Professional		$412.94	$458.83	$504.71
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $475.09 / $557.15 / $598.53	Facility		$475.09	$557.15	$598.53
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $538.67 / $598.53 / $598.53	Professional		$538.67	$598.53	$598.53
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $524.09 / $672.18 / $1,169.00	Facility		$524.09	$672.18	$1,169.00
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $569.69 / $584.50 / $584.50	Facility		$569.69	$584.50	$584.50
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $475.47 / $508.75 / $658.38	Professional		$475.47	$508.75	$658.38
United Facility/Professional Professional Modifier Low / Median / High Price $261.64 / $299.82 / $530.30	Professional		$261.64	$299.82	$530.30
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $281.02 / $281.02 / $350.31	Professional		$281.02	$281.02	$350.31