Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $103.31 / $161.69 / $290.77	Facility		$103.31	$161.69	$290.77
Aetna Facility/Professional Professional Modifier Low / Median / High Price $69.50 / $103.31 / $215.54	Professional		$69.50	$103.31	$215.54
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $274.99 / $572.82 / $1,195.90	Facility		$274.99	$572.82	$1,195.90
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $119.20 / $207.75 / $713.18	Professional		$119.20	$207.75	$713.18
Cigna Facility/Professional Facility Modifier Low / Median / High Price $475.81 / $831.68 / $1,102.72	Facility		$475.81	$831.68	$1,102.72
Cigna Facility/Professional Professional Modifier Low / Median / High Price $82.38 / $152.35 / $266.56	Professional		$82.38	$152.35	$266.56
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $85.30 / $174.93 / $635.38	Facility		$85.30	$174.93	$635.38
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $69.45 / $152.76 / $222.09	Professional		$69.45	$152.76	$222.09
Molina Facility/Professional Professional Modifier Low / Median / High Price $21.52 / $102.70 / $228.88	Professional		$21.52	$102.70	$228.88
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $111.72 / $153.00 / $168.84	Facility		$111.72	$153.00	$168.84
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $113.34 / $113.34 / $116.87	Facility		$113.34	$113.34	$116.87
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $131.44 / $194.03 / $235.87	Professional		$131.44	$194.03	$235.87
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $461.12 / $689.99 / $1,320.55	Facility		$461.12	$689.99	$1,320.55
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $119.20 / $169.88 / $232.70	Professional		$119.20	$169.88	$232.70
United Facility/Professional Professional Modifier Low / Median / High Price $82.65 / $98.38 / $226.32	Professional		$82.65	$98.38	$226.32
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $92.72 / $92.72 / $92.72	Professional		$92.72	$92.72	$92.72