Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $265.83 / $265.83 / $265.83	Facility		$265.83	$265.83	$265.83
Aetna Facility/Professional Professional Modifier Low / Median / High Price $188.61 / $261.17 / $298.88	Professional		$188.61	$261.17	$298.88
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $830.70 / $2,640.81 / $3,961.55	Facility		$830.70	$2,640.81	$3,961.55
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $337.72 / $597.25 / $2,218.13	Professional		$337.72	$597.25	$2,218.13
Cigna Facility/Professional Facility Modifier Low / Median / High Price $500.00 / $870.49 / $1,654.34	Facility		$500.00	$870.49	$1,654.34
Cigna Facility/Professional Professional Modifier Low / Median / High Price $405.39 / $405.39 / $405.39	Professional		$405.39	$405.39	$405.39
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $826.39 / $2,445.16 / $7,407.84	Facility		$826.39	$2,445.16	$7,407.84
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $824.58 / $824.58 / $824.58	Professional		$824.58	$824.58	$824.58
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $50.00 / $65.00	Professional		$50.00	$50.00	$65.00
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $423.71 / $749.22 / $1,139.69	Facility		$423.71	$749.22	$1,139.69
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $331.14 / $533.26 / $856.87	Facility		$331.14	$533.26	$856.87
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $356.73 / $556.22 / $699.37	Professional		$356.73	$556.22	$699.37
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $1,874.47 / $2,568.87 / $4,913.96	Facility		$1,874.47	$2,568.87	$4,913.96
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $337.72 / $492.30 / $662.29	Professional		$337.72	$492.30	$662.29
United Facility/Professional Facility Modifier Low / Median / High Price $650.00 / $1,120.00 / $6,857.00	Facility		$650.00	$1,120.00	$6,857.00
United Facility/Professional Professional Modifier Low / Median / High Price $284.58 / $431.28 / $712.71	Professional		$284.58	$431.28	$712.71
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $803.81 / $803.81 / $803.81	Professional		$803.81	$803.81	$803.81