Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $114.60 / $488.86 / $799.73	Facility		$114.60	$488.86	$799.73
Aetna Facility/Professional Professional Modifier Low / Median / High Price $79.78 / $114.60 / $114.60	Professional		$79.78	$114.60	$114.60
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $128.01 / $195.06 / $503.66	Facility		$128.01	$195.06	$503.66
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $121.91 / $253.27 / $914.33	Professional		$121.91	$253.27	$914.33
Cigna Facility/Professional Facility Modifier Low / Median / High Price $126.78 / $259.14 / $314.77	Facility		$126.78	$259.14	$314.77
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $109.72 / $121.91 / $304.77	Facility		$109.72	$121.91	$304.77
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $109.72 / $121.91 / $304.77	Professional		$109.72	$121.91	$304.77
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 $109.72 / $134.10 / $213.34	Facility		$109.72	$134.10	$213.34
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $121.91 / $213.34 / $365.73	Facility		$121.91	$213.34	$365.73
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $109.72 / $152.38 / $184.08	Professional		$109.72	$152.38	$184.08
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $128.01 / $200.05 / $335.25	Facility		$128.01	$200.05	$335.25
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $134.83 / $237.05 / $283.27	Professional		$134.83	$237.05	$283.27
United Facility/Professional Professional Modifier Low / Median / High Price $51.20 / $63.22 / $136.54	Professional		$51.20	$63.22	$136.54