Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $112.80 / $273.37 / $661.20	Facility		$112.80	$273.37	$661.20
Aetna Facility/Professional Professional Modifier Low / Median / High Price $75.59 / $112.80 / $177.60	Professional		$75.59	$112.80	$177.60
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $120.00 / $192.00 / $811.07	Facility		$120.00	$192.00	$811.07
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $108.00 / $245.29 / $900.00	Professional		$108.00	$245.29	$900.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $124.80 / $245.70 / $312.00	Facility		$124.80	$245.70	$312.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $63.35 / $134.38 / $169.86	Professional		$63.35	$134.38	$169.86
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $118.42 / $150.00 / $342.53	Facility		$118.42	$150.00	$342.53
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $120.00 / $176.40 / $332.00	Professional		$120.00	$176.40	$332.00
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 $120.00 / $120.00 / $252.00	Facility		$120.00	$120.00	$252.00
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $120.00 / $210.00 / $360.00	Facility		$120.00	$210.00	$360.00
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $108.00 / $150.00 / $181.20	Professional		$108.00	$150.00	$181.20
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $126.00 / $196.92 / $330.00	Facility		$126.00	$196.92	$330.00
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $132.72 / $233.69 / $278.64	Professional		$132.72	$233.69	$278.64
United Facility/Professional Professional Modifier Low / Median / High Price $50.40 / $50.40 / $134.40	Professional		$50.40	$50.40	$134.40