Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $54.77 / $79.48 / $107.67	Facility		$54.77	$79.48	$107.67
Aetna Facility/Professional Professional Modifier Low / Median / High Price $42.40 / $54.77 / $76.31	Professional		$42.40	$54.77	$76.31
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $92.73 / $236.78 / $483.21	Facility		$92.73	$236.78	$483.21
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $66.41 / $107.68 / $309.19	Professional		$66.41	$107.68	$309.19
Asuris Northwest Health Facility/Professional Professional Modifier 25 Low / Median / High Price $56.14 / $72.44 / $94.13	Professional	25	$56.14	$72.44	$94.13
Cigna Facility/Professional Professional Modifier Low / Median / High Price $60.48 / $97.46 / $153.85	Professional		$60.48	$97.46	$153.85
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $45.05 / $68.28 / $126.79	Facility		$45.05	$68.28	$126.79
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $45.05 / $63.86 / $115.12	Professional		$45.05	$63.86	$115.12
Molina Facility/Professional Professional Modifier Low / Median / High Price $18.57 / $99.92 / $162.31	Professional		$18.57	$99.92	$162.31
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $72.50 / $104.31 / $124.62	Facility		$72.50	$104.31	$124.62
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $82.90 / $82.90 / $91.42	Facility		$82.90	$82.90	$91.42
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $72.25 / $111.80 / $150.41	Professional		$72.25	$111.80	$150.41
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $181.62 / $252.46 / $483.21	Facility		$181.62	$252.46	$483.21
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $66.87 / $91.62 / $135.21	Professional		$66.87	$91.62	$135.21
United Facility/Professional Professional Modifier Low / Median / High Price $80.52 / $106.14 / $174.77	Professional		$80.52	$106.14	$174.77
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $47.92 / $52.73 / $68.94	Professional		$47.92	$52.73	$68.94