Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $128.78 / $228.79 / $754.87	Facility		$128.78	$228.79	$754.87
Aetna Facility/Professional Professional Modifier Low / Median / High Price $82.20 / $128.78 / $202.76	Professional		$82.20	$128.78	$202.76
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $143.85 / $219.20 / $566.00	Facility		$143.85	$219.20	$566.00
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $123.30 / $267.49 / $1,027.50	Professional		$123.30	$267.49	$1,027.50
Cigna Facility/Professional Facility Modifier Low / Median / High Price $142.47 / $291.22 / $353.75	Facility		$142.47	$291.22	$353.75
Cigna Facility/Professional Professional Modifier Low / Median / High Price $65.42 / $144.71 / $193.84	Professional		$65.42	$144.71	$193.84
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $137.00 / $171.25 / $468.75	Facility		$137.00	$171.25	$468.75
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $137.00 / $232.90 / $423.62	Professional		$137.00	$232.90	$423.62
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 $137.00 / $137.00 / $205.50	Facility		$137.00	$137.00	$205.50
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $137.00 / $239.75 / $411.00	Facility		$137.00	$239.75	$411.00
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $123.30 / $171.25 / $206.87	Professional		$123.30	$171.25	$206.87
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $143.85 / $219.20 / $376.75	Facility		$143.85	$219.20	$376.75
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $151.52 / $266.68 / $318.89	Professional		$151.52	$266.68	$318.89
United Facility/Professional Professional Modifier Low / Median / High Price $57.54 / $57.54 / $153.44	Professional		$57.54	$57.54	$153.44