Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $86.16 / $273.97 / $505.05	Facility		$86.16	$273.97	$505.05
Aetna Facility/Professional Professional Modifier Low / Median / High Price $62.33 / $87.08 / $99.51	Professional		$62.33	$87.08	$99.51
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $55.00 / $55.00 / $55.00	Professional		$55.00	$55.00	$55.00
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $96.24 / $150.41 / $320.81	Facility		$96.24	$150.41	$320.81
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $89.21 / $170.10 / $687.45	Professional		$89.21	$170.10	$687.45
Cigna Facility/Professional Facility Modifier Low / Median / High Price $41.25 / $187.68 / $268.11	Facility		$41.25	$187.68	$268.11
Cigna Facility/Professional Professional Modifier Low / Median / High Price $57.14 / $103.11 / $140.55	Professional		$57.14	$103.11	$140.55
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $91.66 / $134.74 / $313.12	Facility		$91.66	$134.74	$313.12
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $91.66 / $162.00 / $282.98	Professional		$91.66	$162.00	$282.98
Molina Facility/Professional Professional Modifier Low / Median / High Price $75.00 / $89.73 / $97.26	Professional		$75.00	$89.73	$97.26
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $91.66 / $91.66 / $192.49	Facility		$91.66	$91.66	$192.49
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $82.49 / $160.41 / $274.98	Facility		$82.49	$160.41	$274.98
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $82.49 / $114.57 / $138.41	Professional		$82.49	$114.57	$138.41
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $96.24 / $151.24 / $252.07	Facility		$96.24	$151.24	$252.07
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $106.88 / $178.47 / $212.85	Professional		$106.88	$178.47	$212.85
United Facility/Professional Professional Modifier Low / Median / High Price $38.50 / $52.45 / $102.66	Professional		$38.50	$52.45	$102.66