Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $174.09 / $421.90 / $1,020.45	Facility		$174.09	$421.90	$1,020.45
Aetna Facility/Professional Professional Modifier Low / Median / High Price $116.68 / $174.09 / $295.04	Professional		$116.68	$174.09	$295.04
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $194.46 / $296.32 / $765.14	Facility		$194.46	$296.32	$765.14
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $174.09 / $362.17 / $1,389.00	Professional		$174.09	$362.17	$1,389.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $192.61 / $393.68 / $478.21	Facility		$192.61	$393.68	$478.21
Cigna Facility/Professional Professional Modifier Low / Median / High Price $88.49 / $195.94 / $262.19	Professional		$88.49	$195.94	$262.19
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $185.20 / $231.50 / $633.75	Facility		$185.20	$231.50	$633.75
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $185.20 / $314.83 / $572.72	Professional		$185.20	$314.83	$572.72
Molina Facility/Professional Professional Modifier Low / Median / High Price $75.00 / $75.00 / $75.00	Professional		$75.00	$75.00	$75.00
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $185.20 / $185.20 / $277.80	Facility		$185.20	$185.20	$277.80
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $185.20 / $324.10 / $555.60	Facility		$185.20	$324.10	$555.60
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $166.68 / $231.50 / $279.64	Professional		$166.68	$231.50	$279.64
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $194.46 / $296.32 / $509.30	Facility		$194.46	$296.32	$509.30
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $204.83 / $360.30 / $430.34	Professional		$204.83	$360.30	$430.34
United Facility/Professional Professional Modifier Low / Median / High Price $77.78 / $77.78 / $207.42	Professional		$77.78	$77.78	$207.42