Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $666.49 / $1,013.12 / $1,579.58	Facility		$666.49	$1,013.12	$1,579.58
Aetna Facility/Professional Professional Modifier Low / Median / High Price $299.87 / $666.49 / $1,512.93	Professional		$299.87	$666.49	$1,512.93
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $740.72 / $757.12 / $888.86	Professional		$740.72	$757.12	$888.86
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $864.79 / $2,054.06 / $4,711.96	Facility		$864.79	$2,054.06	$4,711.96
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $703.30 / $864.29 / $5,094.49	Professional		$703.30	$864.29	$5,094.49
Cigna Facility/Professional Facility Modifier Low / Median / High Price $710.11 / $710.11 / $710.11	Facility		$710.11	$710.11	$710.11
Cigna Facility/Professional Professional Modifier Low / Median / High Price $518.38 / $518.38 / $710.11	Professional		$518.38	$518.38	$710.11
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $568.75 / $987.62 / $2,587.50	Facility		$568.75	$987.62	$2,587.50
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $569.37 / $999.62 / $1,918.14	Professional		$569.37	$999.62	$1,918.14
Molina Facility/Professional Professional Modifier Low / Median / High Price $681.40 / $757.12 / $832.83	Professional		$681.40	$757.12	$832.83
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $783.96 / $964.47 / $1,022.99	Facility		$783.96	$964.47	$1,022.99
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $888.86 / $987.62 / $1,022.99	Professional		$888.86	$987.62	$1,022.99
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $864.79 / $1,109.14 / $1,928.94	Facility		$864.79	$1,109.14	$1,928.94
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $940.03 / $964.47 / $964.47	Facility		$940.03	$964.47	$964.47
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $784.58 / $839.48 / $1,086.38	Professional		$784.58	$839.48	$1,086.38
United Facility/Professional Professional Modifier Low / Median / High Price $416.96 / $486.45 / $860.38	Professional		$416.96	$486.45	$860.38
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $544.83 / $806.10 / $806.10	Professional		$544.83	$806.10	$806.10