Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $190.26 / $322.08 / $1,115.22	Facility		$190.26	$322.08	$1,115.22
Aetna Facility/Professional Professional Modifier Low / Median / High Price $133.13 / $190.26 / $387.29	Professional		$133.13	$190.26	$387.29
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $212.52 / $323.83 / $836.20	Facility		$212.52	$323.83	$836.20
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $182.16 / $413.67 / $1,518.00	Professional		$182.16	$413.67	$1,518.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $210.50 / $414.41 / $522.62	Facility		$210.50	$414.41	$522.62
Cigna Facility/Professional Professional Modifier Low / Median / High Price $102.27 / $213.95 / $276.07	Professional		$102.27	$213.95	$276.07
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $199.64 / $255.60 / $626.10	Facility		$199.64	$255.60	$626.10
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $202.40 / $297.52 / $560.16	Professional		$202.40	$297.52	$560.16
Molina Facility/Professional Professional Modifier Low / Median / High Price $75.00 / $198.15 / $214.78	Professional		$75.00	$198.15	$214.78
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $202.40 / $202.40 / $425.04	Facility		$202.40	$202.40	$425.04
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $202.40 / $354.20 / $607.20	Facility		$202.40	$354.20	$607.20
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $182.16 / $253.00 / $305.62	Professional		$182.16	$253.00	$305.62
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $212.52 / $332.14 / $556.60	Facility		$212.52	$332.14	$556.60
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $223.85 / $393.97 / $470.59	Professional		$223.85	$393.97	$470.59
United Facility/Professional Professional Modifier Low / Median / High Price $80.09 / $85.01 / $226.69	Professional		$80.09	$85.01	$226.69