Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $43.63 / $70.83 / $133.41	Professional		$43.63	$70.83	$133.41
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $21.93 / $89.14 / $314.00	Professional	25	$21.93	$89.14	$314.00
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $114.61 / $114.61 / $410.04	Facility		$114.61	$114.61	$410.04
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $49.30 / $124.09 / $719.63	Professional		$49.30	$124.09	$719.63
Cigna Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $96.76 / $211.82	Professional		$50.00	$96.76	$211.82
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $57.71 / $99.73 / $204.09	Facility		$57.71	$99.73	$204.09
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $58.22 / $100.58 / $204.09	Professional		$58.22	$100.58	$204.09
Molina Facility/Professional Professional Modifier Low / Median / High Price $26.96 / $158.36 / $277.09	Professional		$26.96	$158.36	$277.09
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $72.00 / $149.34 / $170.18	Facility		$72.00	$149.34	$170.18
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $114.61 / $114.61 / $114.61	Facility		$114.61	$114.61	$114.61
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $70.45 / $120.44 / $219.76	Professional		$70.45	$120.44	$219.76
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $48.94 / $86.56 / $116.46	Professional		$48.94	$86.56	$116.46
United Facility/Professional Professional Modifier Low / Median / High Price $88.20 / $125.20 / $231.56	Professional		$88.20	$125.20	$231.56
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $48.00 / $75.00 / $130.00	Professional		$48.00	$75.00	$130.00