Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $357.20 / $1,183.32 / $2,492.80	Facility		$357.20	$1,183.32	$2,492.80
Aetna Facility/Professional Professional Modifier Low / Median / High Price $357.20 / $357.20 / $357.20	Professional		$357.20	$357.20	$357.20
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $399.00 / $608.00 / $1,569.93	Facility		$399.00	$608.00	$1,569.93
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $380.00 / $807.97 / $2,850.00	Professional		$380.00	$807.97	$2,850.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $395.20 / $807.76 / $981.21	Facility		$395.20	$807.76	$981.21
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $342.00 / $380.00 / $950.00	Facility		$342.00	$380.00	$950.00
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $342.00 / $380.00 / $950.00	Professional		$342.00	$380.00	$950.00
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 $342.00 / $418.00 / $665.00	Facility		$342.00	$418.00	$665.00
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $380.00 / $665.00 / $1,140.00	Facility		$380.00	$665.00	$1,140.00
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $342.00 / $475.00 / $573.79	Professional		$342.00	$475.00	$573.79
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $399.00 / $623.58 / $1,045.00	Facility		$399.00	$623.58	$1,045.00
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $420.28 / $739.45 / $883.91	Professional		$420.28	$739.45	$883.91
United Facility/Professional Professional Modifier Low / Median / High Price $159.60 / $159.60 / $425.60	Professional		$159.60	$159.60	$425.60