Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $65.02 / $65.02 / $117.78	Facility		$65.02	$65.02	$117.78
Aetna Facility/Professional Professional Modifier Low / Median / High Price $33.11 / $50.29 / $65.02	Professional		$33.11	$50.29	$65.02
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $82.80 / $132.47 / $299.75	Facility		$82.80	$132.47	$299.75
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $61.79 / $109.50 / $572.25	Professional		$61.79	$109.50	$572.25
Cigna Facility/Professional Facility Modifier Low / Median / High Price $106.00 / $108.00 / $115.00	Facility		$106.00	$108.00	$115.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $49.94 / $76.31 / $186.27	Professional		$49.94	$76.31	$186.27
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $48.75 / $70.98 / $160.91	Facility		$48.75	$70.98	$160.91
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $49.92 / $71.34 / $147.35	Professional		$49.92	$71.34	$147.35
Molina Facility/Professional Professional Modifier Low / Median / High Price $45.00 / $50.00 / $75.00	Professional		$45.00	$50.00	$75.00
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $87.06 / $129.79 / $133.33	Facility		$87.06	$129.79	$133.33
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $67.06 / $89.69 / $89.69	Facility		$67.06	$89.69	$89.69
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $90.40 / $125.56 / $167.86	Professional		$90.40	$125.56	$167.86
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $84.71 / $99.36 / $155.08	Facility		$84.71	$99.36	$155.08
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $64.89 / $68.66 / $114.38	Professional		$64.89	$68.66	$114.38
United Facility/Professional Professional Modifier Low / Median / High Price $53.73 / $66.77 / $175.23	Professional		$53.73	$66.77	$175.23
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $43.14 / $43.14 / $43.14	Professional		$43.14	$43.14	$43.14