Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $90.80 / $147.52 / $189.91	Facility		$90.80	$147.52	$189.91
Aetna Facility/Professional Professional Modifier Low / Median / High Price $62.17 / $76.08 / $116.26	Professional		$62.17	$76.08	$116.26
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $112.80 / $140.88 / $339.11	Facility		$112.80	$140.88	$339.11
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $98.00 / $158.61 / $530.02	Professional		$98.00	$158.61	$530.02
Asuris Northwest Health Facility/Professional Professional Modifier 25 Low / Median / High Price $88.30 / $100.14 / $125.17	Professional	25	$88.30	$100.14	$125.17
Cigna Facility/Professional Professional Modifier Low / Median / High Price $96.18 / $152.15 / $218.40	Professional		$96.18	$152.15	$218.40
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $69.44 / $95.04 / $186.28	Facility		$69.44	$95.04	$186.28
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $69.44 / $93.04 / $178.31	Professional		$69.44	$93.04	$178.31
Molina Facility/Professional Professional Modifier Low / Median / High Price $27.84 / $148.16 / $258.09	Professional		$27.84	$148.16	$258.09
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $102.11 / $156.11 / $170.18	Facility		$102.11	$156.11	$170.18
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $110.11 / $112.80 / $112.80	Facility		$110.11	$112.80	$112.80
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $107.00 / $161.10 / $209.21	Professional		$107.00	$161.10	$209.21
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $102.59 / $135.74 / $196.60	Professional		$102.59	$135.74	$196.60
United Facility/Professional Professional Modifier Low / Median / High Price $100.19 / $135.13 / $238.46	Professional		$100.19	$135.13	$238.46
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $70.12 / $78.62 / $90.46	Professional		$70.12	$78.62	$90.46