Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $486.44 / $1,104.22 / $1,152.85	Facility		$486.44	$1,104.22	$1,152.85
Aetna Facility/Professional Professional Modifier Low / Median / High Price $401.37 / $486.44 / $1,152.85	Professional		$401.37	$486.44	$1,152.85
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $573.84 / $573.84 / $573.84	Professional		$573.84	$573.84	$573.84
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $655.45 / $1,352.33 / $3,201.26	Facility		$655.45	$1,352.33	$3,201.26
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $474.67 / $643.74 / $3,997.65	Professional		$474.67	$643.74	$3,997.65
Cigna Facility/Professional Facility Modifier Low / Median / High Price $382.03 / $382.03 / $382.03	Facility		$382.03	$382.03	$382.03
Cigna Facility/Professional Professional Modifier Low / Median / High Price $278.88 / $278.88 / $382.03	Professional		$278.88	$278.88	$382.03
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $379.01 / $722.54 / $1,723.12	Facility		$379.01	$722.54	$1,723.12
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $379.43 / $711.10 / $1,277.66	Professional		$379.43	$711.10	$1,277.66
Molina Facility/Professional Professional Modifier Low / Median / High Price $516.45 / $573.84 / $631.22	Professional		$516.45	$573.84	$631.22
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $594.17 / $730.99 / $802.74	Facility		$594.17	$730.99	$802.74
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $594.65 / $748.53 / $802.74	Professional		$594.65	$748.53	$802.74
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $655.45 / $840.64 / $1,461.98	Facility		$655.45	$840.64	$1,461.98
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $712.47 / $730.99 / $730.99	Facility		$712.47	$730.99	$730.99
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $594.65 / $636.25 / $823.38	Professional		$594.65	$636.25	$823.38
United Facility/Professional Professional Modifier Low / Median / High Price $300.36 / $400.48 / $573.04	Professional		$300.36	$400.48	$573.04
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $365.32 / $365.32 / $365.89	Professional		$365.32	$365.32	$365.89