Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $155.58 / $276.39 / $911.96	Facility		$155.58	$276.39	$911.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $82.76 / $155.58 / $260.27	Professional		$82.76	$155.58	$260.27
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $165.51 / $264.82 / $579.29	Facility		$165.51	$264.82	$579.29
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $148.96 / $307.44 / $1,241.33	Professional		$148.96	$307.44	$1,241.33
Cigna Facility/Professional Facility Modifier Low / Median / High Price $54.73 / $266.80 / $430.32	Facility		$54.73	$266.80	$430.32
Cigna Facility/Professional Professional Modifier Low / Median / High Price $84.13 / $185.42 / $234.13	Professional		$84.13	$185.42	$234.13
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $159.21 / $224.64 / $512.58	Facility		$159.21	$224.64	$512.58
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $159.21 / $243.30 / $449.57	Professional		$159.21	$243.30	$449.57
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 $165.51 / $165.51 / $347.57	Facility		$165.51	$165.51	$347.57
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $148.96 / $287.99 / $496.53	Facility		$148.96	$287.99	$496.53
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $148.96 / $206.89 / $249.92	Professional		$148.96	$206.89	$249.92
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $173.79 / $271.60 / $455.15	Facility		$173.79	$271.60	$455.15
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $183.05 / $321.91 / $384.68	Professional		$183.05	$321.91	$384.68
United Facility/Professional Facility Modifier Low / Median / High Price $165.51 / $198.61 / $198.61	Facility		$165.51	$198.61	$198.61
United Facility/Professional Professional Modifier Low / Median / High Price $69.51 / $69.51 / $185.37	Professional		$69.51	$69.51	$185.37