Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $562.38 / $2,116.00 / $9,132.48	Facility		$562.38	$2,116.00	$9,132.48
Aetna Facility/Professional Professional Modifier Low / Median / High Price $471.62 / $529.61 / $833.02	Professional		$471.62	$529.61	$833.02
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $625.01 / $750.01 / $750.01	Professional		$625.01	$750.01	$750.01
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $729.71 / $1,692.88 / $4,222.76	Facility		$729.71	$1,692.88	$4,222.76
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $571.41 / $729.71 / $5,103.60	Professional		$571.41	$729.71	$5,103.60
Cigna Facility/Professional Facility Modifier Low / Median / High Price $544.74 / $544.74 / $544.74	Facility		$544.74	$544.74	$544.74
Cigna Facility/Professional Professional Modifier Low / Median / High Price $397.66 / $397.66 / $544.74	Professional		$397.66	$397.66	$544.74
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $504.14 / $858.98 / $2,283.55	Facility		$504.14	$858.98	$2,283.55
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $504.69 / $858.98 / $1,701.34	Professional		$504.69	$858.98	$1,701.34
Molina Facility/Professional Professional Modifier Low / Median / High Price $574.96 / $638.85 / $702.73	Professional		$574.96	$638.85	$702.73
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $661.49 / $813.81 / $842.18	Facility		$661.49	$813.81	$842.18
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $661.49 / $833.34 / $842.18	Professional		$661.49	$833.34	$842.18
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $729.71 / $935.88 / $1,627.62	Facility		$729.71	$935.88	$1,627.62
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $793.19 / $813.81 / $813.81	Facility		$793.19	$813.81	$813.81
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $662.02 / $708.34 / $916.67	Professional		$662.02	$708.34	$916.67
United Facility/Professional Professional Modifier Low / Median / High Price $369.77 / $399.93 / $763.02	Professional		$369.77	$399.93	$763.02
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $390.30 / $390.30 / $537.21	Professional		$390.30	$390.30	$537.21