Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $394.09 / $894.58 / $933.99	Facility		$394.09	$894.58	$933.99
Aetna Facility/Professional Professional Modifier Low / Median / High Price $315.82 / $394.09 / $681.78	Professional		$315.82	$394.09	$681.78
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $454.82 / $545.79 / $606.42	Professional		$454.82	$545.79	$606.42
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $531.01 / $1,162.33 / $3,120.86	Facility		$531.01	$1,162.33	$3,120.86
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $442.69 / $568.11 / $4,002.47	Professional		$442.69	$568.11	$4,002.47
Cigna Facility/Professional Facility Modifier Low / Median / High Price $459.90 / $459.90 / $459.90	Facility		$459.90	$459.90	$459.90
Cigna Facility/Professional Professional Modifier Low / Median / High Price $335.73 / $335.73 / $459.90	Professional		$335.73	$335.73	$459.90
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $381.74 / $645.19 / $1,661.77	Facility		$381.74	$645.19	$1,661.77
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $382.16 / $649.72 / $1,286.76	Professional		$382.16	$649.72	$1,286.76
Molina Facility/Professional Professional Modifier Low / Median / High Price $418.41 / $464.90 / $511.39	Professional		$418.41	$464.90	$511.39
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $481.38 / $592.22 / $606.42	Facility		$481.38	$592.22	$606.42
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $481.76 / $606.42 / $667.07	Professional		$481.76	$606.42	$667.07
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $531.01 / $681.05 / $1,184.44	Facility		$531.01	$681.05	$1,184.44
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $577.21 / $592.22 / $592.22	Facility		$577.21	$592.22	$592.22
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $481.76 / $515.47 / $667.07	Professional		$481.76	$515.47	$667.07
United Facility/Professional Professional Modifier Low / Median / High Price $302.54 / $405.20 / $577.21	Professional		$302.54	$405.20	$577.21
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $139.47 / $139.47 / $379.58	Professional		$139.47	$139.47	$379.58