Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $465.58 / $886.00 / $1,825.84	Facility		$465.58	$886.00	$1,825.84
Aetna Facility/Professional Professional Modifier Low / Median / High Price $378.90 / $465.58 / $1,103.42	Professional		$378.90	$465.58	$1,103.42
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $537.33 / $537.33 / $537.33	Professional		$537.33	$537.33	$537.33
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $627.34 / $1,364.32 / $3,490.95	Facility		$627.34	$1,364.32	$3,490.95
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $520.23 / $627.34 / $3,773.79	Professional		$520.23	$627.34	$3,773.79
Cigna Facility/Professional Facility Modifier Low / Median / High Price $440.05 / $440.05 / $440.05	Facility		$440.05	$440.05	$440.05
Cigna Facility/Professional Professional Modifier Low / Median / High Price $321.24 / $321.24 / $440.05	Professional		$321.24	$321.24	$440.05
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $420.42 / $716.44 / $1,913.43	Facility		$420.42	$716.44	$1,913.43
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $420.88 / $730.77 / $1,417.50	Professional		$420.88	$730.77	$1,417.50
Molina Facility/Professional Professional Modifier Low / Median / High Price $494.31 / $549.24 / $604.16	Professional		$494.31	$549.24	$604.16
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $568.70 / $699.65 / $757.79	Facility		$568.70	$699.65	$757.79
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $644.79 / $716.44 / $757.79	Professional		$644.79	$716.44	$757.79
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $627.34 / $804.60 / $1,399.30	Facility		$627.34	$804.60	$1,399.30
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $681.92 / $699.65 / $699.65	Facility		$681.92	$699.65	$699.65
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $569.16 / $608.97 / $788.08	Professional		$569.16	$608.97	$788.08
United Facility/Professional Professional Modifier Low / Median / High Price $333.42 / $500.13 / $636.13	Professional		$333.42	$500.13	$636.13
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $403.47 / $403.47 / $424.98	Professional		$403.47	$403.47	$424.98