Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $305.77 / $694.10 / $724.68	Facility		$305.77	$694.10	$724.68
Aetna Facility/Professional Professional Modifier Low / Median / High Price $264.20 / $305.77 / $724.68	Professional		$264.20	$305.77	$724.68
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $352.88 / $352.88 / $352.88	Professional		$352.88	$352.88	$352.88
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $412.00 / $935.48 / $2,270.36	Facility		$412.00	$935.48	$2,270.36
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $339.94 / $431.87 / $2,957.04	Professional		$339.94	$431.87	$2,957.04
Cigna Facility/Professional Facility Modifier Low / Median / High Price $293.77 / $293.77 / $293.77	Facility		$293.77	$293.77	$293.77
Cigna Facility/Professional Professional Modifier Low / Median / High Price $214.45 / $214.45 / $293.77	Professional		$214.45	$214.45	$293.77
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $266.17 / $470.51 / $1,210.31	Facility		$266.17	$470.51	$1,210.31
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $266.45 / $470.51 / $897.83	Professional		$266.45	$470.51	$897.83
Molina Facility/Professional Professional Modifier Low / Median / High Price $324.63 / $360.71 / $396.78	Professional		$324.63	$360.71	$396.78
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $373.50 / $459.48 / $528.40	Facility		$373.50	$459.48	$528.40
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $423.46 / $470.51 / $528.40	Professional		$423.46	$470.51	$528.40
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $412.00 / $528.40 / $918.96	Facility		$412.00	$528.40	$918.96
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $447.84 / $459.48 / $459.48	Facility		$447.84	$459.48	$459.48
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $373.79 / $399.93 / $517.55	Professional		$373.79	$399.93	$517.55
United Facility/Professional Facility Modifier Low / Median / High Price $564.00 / $676.80 / $676.80	Facility		$564.00	$676.80	$676.80
United Facility/Professional Professional Modifier Low / Median / High Price $211.03 / $316.55 / $402.62	Professional		$211.03	$316.55	$402.62
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $189.95 / $189.95 / $272.08	Professional		$189.95	$189.95	$272.08