Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $35.25 / $112.75 / $178.50	Facility		$35.25	$112.75	$178.50
Aetna Facility/Professional Professional Modifier Low / Median / High Price $13.25 / $17.50 / $48.75	Professional		$13.25	$17.50	$48.75
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $26.25 / $40.00 / $103.29	Facility		$26.25	$40.00	$103.29
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $25.00 / $51.90 / $187.50	Professional		$25.00	$51.90	$187.50
Cigna Facility/Professional Facility Modifier Low / Median / High Price $26.00 / $53.14 / $64.55	Facility		$26.00	$53.14	$64.55
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $22.50 / $25.00 / $42.50	Facility		$22.50	$25.00	$42.50
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $22.50 / $25.00 / $62.50	Professional		$22.50	$25.00	$62.50
Molina Facility/Professional Professional Modifier Low / Median / High Price $75.00 / $75.00 / $75.00	Professional		$75.00	$75.00	$75.00
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $22.50 / $27.50 / $43.75	Facility		$22.50	$27.50	$43.75
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $25.00 / $43.75 / $77.50	Facility		$25.00	$43.75	$77.50
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $22.50 / $31.25 / $37.75	Professional		$22.50	$31.25	$37.75
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $26.25 / $40.00 / $68.75	Facility		$26.25	$40.00	$68.75
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $27.65 / $48.49 / $58.05	Professional		$27.65	$48.49	$58.05
United Facility/Professional Professional Modifier Low / Median / High Price $10.50 / $10.50 / $28.00	Professional		$10.50	$10.50	$28.00