Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $126.42 / $126.42 / $126.42	Facility		$126.42	$126.42	$126.42
Aetna Facility/Professional Professional Modifier Low / Median / High Price $112.39 / $141.06 / $194.48	Professional		$112.39	$141.06	$194.48
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $76.00 / $100.00 / $761.52	Facility		$76.00	$100.00	$761.52
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $25.86 / $164.86 / $959.04	Professional		$25.86	$164.86	$959.04
Cigna Facility/Professional Facility Modifier Low / Median / High Price $147.10 / $147.10 / $147.10	Facility		$147.10	$147.10	$147.10
Cigna Facility/Professional Professional Modifier Low / Median / High Price $107.38 / $125.04 / $125.04	Professional		$107.38	$125.04	$125.04
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $315.81 / $383.43 / $588.87	Facility		$315.81	$383.43	$588.87
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $162.69 / $285.50 / $447.62	Professional		$162.69	$285.50	$447.62
Molina Facility/Professional Professional Modifier Low / Median / High Price $21.30 / $30.00 / $75.00	Professional		$21.30	$30.00	$75.00
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $79,999.20 / $79,999.20 / $79,999.20	Facility		$79,999.20	$79,999.20	$79,999.20
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $22.16 / $22.16 / $22.16	Facility		$22.16	$22.16	$22.16
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $17.57 / $44.66 / $229.33	Professional		$17.57	$44.66	$229.33
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $25.86 / $25.86 / $31.49	Professional		$25.86	$25.86	$31.49
United Facility/Professional Professional Modifier Low / Median / High Price $11.78 / $14.84 / $28.77	Professional		$11.78	$14.84	$28.77
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $164.86 / $164.86 / $164.86	Professional		$164.86	$164.86	$164.86