Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $107.12 / $165.91 / $257.20	Facility		$107.12	$165.91	$257.20
Aetna Facility/Professional Professional Modifier Low / Median / High Price $58.11 / $107.12 / $214.24	Professional		$58.11	$107.12	$214.24
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $183.54 / $412.20 / $726.13	Facility		$183.54	$412.20	$726.13
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $116.54 / $212.49 / $737.93	Professional		$116.54	$212.49	$737.93
Cigna Facility/Professional Facility Modifier Low / Median / High Price $445.82 / $623.61 / $858.10	Facility		$445.82	$623.61	$858.10
Cigna Facility/Professional Professional Modifier Low / Median / High Price $69.28 / $134.08 / $278.27	Professional		$69.28	$134.08	$278.27
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $74.28 / $156.03 / $316.52	Facility		$74.28	$156.03	$316.52
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $69.15 / $139.43 / $230.36	Professional		$69.15	$139.43	$230.36
Molina Facility/Professional Professional Modifier Low / Median / High Price $18.30 / $108.67 / $185.47	Professional		$18.30	$108.67	$185.47
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $98.98 / $151.05 / $170.85	Facility		$98.98	$151.05	$170.85
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $116.54 / $116.54 / $120.05	Facility		$116.54	$116.54	$120.05
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $128.94 / $200.53 / $240.55	Professional		$128.94	$200.53	$240.55
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $342.07 / $508.09 / $990.17	Facility		$342.07	$508.09	$990.17
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $122.43 / $174.68 / $239.01	Professional		$122.43	$174.68	$239.01
United Facility/Professional Professional Modifier Low / Median / High Price $68.92 / $93.37 / $238.85	Professional		$68.92	$93.37	$238.85
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $96.47 / $96.47 / $96.47	Professional		$96.47	$96.47	$96.47