Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $54.95 / $54.95 / $54.95	Facility		$54.95	$54.95	$54.95
Aetna Facility/Professional Professional Modifier Low / Median / High Price $30.70 / $54.95 / $59.80	Professional		$30.70	$54.95	$59.80
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $78.59 / $106.87 / $208.63	Facility		$78.59	$106.87	$208.63
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $69.30 / $118.20 / $494.40	Professional		$69.30	$118.20	$494.40
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $38.03 / $128.30 / $321.62	Facility		$38.03	$128.30	$321.62
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $174.74 / $174.74 / $174.74	Professional		$174.74	$174.74	$174.74
Molina Facility/Professional Professional Modifier Low / Median / High Price $45.00 / $50.00 / $50.00	Professional		$45.00	$50.00	$50.00
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $45.48 / $54.21 / $60.22	Facility		$45.48	$54.21	$60.22
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $67.95 / $67.95 / $78.59	Facility		$67.95	$67.95	$78.59
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $78.59 / $117.37 / $156.02	Professional		$78.59	$117.37	$156.02
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $77.98 / $106.87 / $204.42	Facility		$77.98	$106.87	$204.42
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $69.30 / $110.36 / $152.31	Professional		$69.30	$110.36	$152.31
United Facility/Professional Professional Modifier Low / Median / High Price $64.48 / $101.78 / $187.74	Professional		$64.48	$101.78	$187.74