Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $109.95 / $217.11 / $5,796.58	Facility		$109.95	$217.11	$5,796.58
Aetna Facility/Professional Professional Modifier Low / Median / High Price $70.00 / $109.95 / $217.11	Professional		$70.00	$109.95	$217.11
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $111.51 / $4,348.10 / $8,317.42	Facility		$111.51	$4,348.10	$8,317.42
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $114.78 / $189.47 / $1,870.00	Professional		$114.78	$189.47	$1,870.00
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $109.32 / $185.23 / $3,114.11	Facility		$109.32	$185.23	$3,114.11
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $109.32 / $183.67 / $1,403.75	Professional		$109.32	$183.67	$1,403.75
Molina Facility/Professional Professional Modifier Low / Median / High Price $25.86 / $162.60 / $270.47	Professional		$25.86	$162.60	$270.47
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $116.62 / $160.30 / $167.96	Facility		$116.62	$160.30	$167.96
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $111.51 / $112.34 / $726.24	Facility		$111.51	$112.34	$726.24
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $115.20 / $187.18 / $228.70	Professional		$115.20	$187.18	$228.70
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $2,819.55 / $4,345.60 / $8,317.42	Facility		$2,819.55	$4,345.60	$8,317.42
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $114.58 / $160.41 / $216.06	Professional		$114.58	$160.41	$216.06
United Facility/Professional Facility Modifier Low / Median / High Price $879.00 / $1,689.00 / $7,385.00	Facility		$879.00	$1,689.00	$7,385.00
United Facility/Professional Professional Modifier Low / Median / High Price $103.99 / $170.10 / $240.58	Professional		$103.99	$170.10	$240.58