Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $517.29 / $1,174.27 / $1,226.00	Facility		$517.29	$1,174.27	$1,226.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $398.02 / $517.29 / $1,226.00	Professional		$398.02	$517.29	$1,226.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $610.23 / $610.23 / $610.23	Professional		$610.23	$610.23	$610.23
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $697.03 / $1,438.13 / $3,301.32	Facility		$697.03	$1,438.13	$3,301.32
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $482.00 / $690.18 / $4,654.76	Professional		$482.00	$690.18	$4,654.76
Cigna Facility/Professional Facility Modifier Low / Median / High Price $380.63 / $380.63 / $380.63	Facility		$380.63	$380.63	$380.63
Cigna Facility/Professional Professional Modifier Low / Median / High Price $277.86 / $277.86 / $380.63	Professional		$277.86	$277.86	$380.63
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $375.83 / $756.23 / $1,710.00	Facility		$375.83	$756.23	$1,710.00
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $376.24 / $756.23 / $1,266.90	Professional		$376.24	$756.23	$1,266.90
Molina Facility/Professional Professional Modifier Low / Median / High Price $549.20 / $610.23 / $671.25	Professional		$549.20	$610.23	$671.25
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $631.85 / $777.37 / $796.03	Facility		$631.85	$777.37	$796.03
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $766.73 / $796.03 / $796.03	Professional		$766.73	$796.03	$796.03
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $697.03 / $893.98 / $1,554.74	Facility		$697.03	$893.98	$1,554.74
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $757.67 / $777.37 / $777.37	Facility		$757.67	$777.37	$777.37
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $632.36 / $676.63 / $875.63	Professional		$632.36	$676.63	$875.63
United Facility/Professional Professional Modifier Low / Median / High Price $297.85 / $448.76 / $568.25	Professional		$297.85	$448.76	$568.25
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $404.16 / $404.16 / $412.43	Professional		$404.16	$404.16	$412.43