Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $54.75 / $74.63 / $109.35	Facility		$54.75	$74.63	$109.35
Aetna Facility/Professional Professional Modifier Low / Median / High Price $38.70 / $65.38 / $109.35	Professional		$38.70	$65.38	$109.35
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $108.27 / $190.76 / $190.76	Facility		$108.27	$190.76	$190.76
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $57.58 / $114.75 / $513.01	Professional		$57.58	$114.75	$513.01
Cigna Facility/Professional Professional Modifier Low / Median / High Price $52.26 / $103.06 / $214.98	Professional		$52.26	$103.06	$214.98
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $39.11 / $71.34 / $123.63	Facility		$39.11	$71.34	$123.63
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $39.11 / $70.56 / $123.63	Professional		$39.11	$70.56	$123.63
Molina Facility/Professional Professional Modifier Low / Median / High Price $18.99 / $98.25 / $174.13	Professional		$18.99	$98.25	$174.13
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $79.86 / $150.36 / $162.13	Facility		$79.86	$150.36	$162.13
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $108.27 / $108.27 / $108.27	Facility		$108.27	$108.27	$108.27
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $64.73 / $111.84 / $202.72	Professional		$64.73	$111.84	$202.72
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $161.12 / $161.12 / $161.12	Facility		$161.12	$161.12	$161.12
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $58.21 / $104.79 / $171.22	Professional		$58.21	$104.79	$171.22
United Facility/Professional Professional Modifier Low / Median / High Price $95.34 / $138.46 / $228.00	Professional		$95.34	$138.46	$228.00
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $41.12 / $66.25 / $89.08	Professional		$41.12	$66.25	$89.08