Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $277.73 / $630.45 / $1,872.85	Facility		$277.73	$630.45	$1,872.85
Aetna Facility/Professional Professional Modifier Low / Median / High Price $213.19 / $271.89 / $480.47	Professional		$213.19	$271.89	$480.47
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $401.26 / $401.26 / $411.56	Professional		$401.26	$401.26	$411.56
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $360.37 / $1,163.33 / $2,238.26	Facility		$360.37	$1,163.33	$2,238.26
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $300.43 / $407.33 / $3,677.85	Professional		$300.43	$407.33	$3,677.85
Cigna Facility/Professional Facility Modifier Low / Median / High Price $261.02 / $264.44 / $264.44	Facility		$261.02	$264.44	$264.44
Cigna Facility/Professional Professional Modifier Low / Median / High Price $193.04 / $193.04 / $264.44	Professional		$193.04	$193.04	$264.44
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $258.89 / $437.56 / $1,127.74	Facility		$258.89	$437.56	$1,127.74
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $259.17 / $440.46 / $873.01	Professional		$259.17	$440.46	$873.01
Molina Facility/Professional Professional Modifier Low / Median / High Price $283.95 / $315.50 / $347.05	Professional		$283.95	$315.50	$347.05
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $326.68 / $401.90 / $421.40	Facility		$326.68	$401.90	$421.40
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $370.40 / $411.55 / $432.13	Professional		$370.40	$411.55	$432.13
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $360.37 / $462.18 / $803.80	Facility		$360.37	$462.18	$803.80
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $391.72 / $401.90 / $401.90	Facility		$391.72	$401.90	$401.90
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $326.94 / $349.82 / $452.71	Professional		$326.94	$349.82	$452.71
United Facility/Professional Professional Modifier Low / Median / High Price $189.83 / $221.47 / $391.72	Professional		$189.83	$221.47	$391.72
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $234.18 / $234.18 / $349.82	Professional		$234.18	$234.18	$349.82