Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $115.68 / $226.32 / $400.75	Facility		$115.68	$226.32	$400.75
Aetna Facility/Professional Professional Modifier Low / Median / High Price $69.84 / $87.64 / $127.94	Professional		$69.84	$87.64	$127.94
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $135.44 / $191.01 / $383.01	Facility		$135.44	$191.01	$383.01
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $113.78 / $189.13 / $636.69	Professional		$113.78	$189.13	$636.69
Cigna Facility/Professional Professional Modifier Low / Median / High Price $103.56 / $157.79 / $250.12	Professional		$103.56	$157.79	$250.12
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $292.88 / $292.88 / $362.83	Professional		$292.88	$292.88	$362.83
Molina Facility/Professional Professional Modifier Low / Median / High Price $59.11 / $76.92 / $179.31	Professional		$59.11	$76.92	$179.31
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $142.93 / $193.84 / $203.01	Facility		$142.93	$193.84	$203.01
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $131.35 / $135.44 / $135.44	Facility		$131.35	$135.44	$135.44
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $120.96 / $187.08 / $250.95	Professional		$120.96	$187.08	$250.95
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $115.42 / $158.88 / $224.55	Professional		$115.42	$158.88	$224.55
United Facility/Professional Professional Modifier Low / Median / High Price $127.40 / $168.73 / $288.68	Professional		$127.40	$168.73	$288.68
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $82.34 / $88.51 / $109.82	Professional		$82.34	$88.51	$109.82