Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $101.55 / $109.39 / $243.36	Professional		$101.55	$109.39	$243.36
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $997.78 / $997.78	Facility		$100.00	$997.78	$997.78
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $17.98 / $161.11 / $229.78	Professional		$17.98	$161.11	$229.78
Cigna Facility/Professional Facility Modifier Low / Median / High Price $134.41 / $134.41 / $134.41	Facility		$134.41	$134.41	$134.41
Cigna Facility/Professional Professional Modifier Low / Median / High Price $114.26 / $134.41 / $162.40	Professional		$114.26	$134.41	$162.40
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $218.84 / $218.84 / $218.84	Facility		$218.84	$218.84	$218.84
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $218.84 / $218.84 / $218.84	Professional		$218.84	$218.84	$218.84
Molina Facility/Professional Professional Modifier Low / Median / High Price $21.67 / $164.14 / $218.84	Professional		$21.67	$164.14	$218.84
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $196.96 / $213.71 / $240.72	Facility		$196.96	$213.71	$240.72
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $207.90 / $218.84 / $218.84	Professional		$207.90	$218.84	$218.84
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $18.97 / $191.62 / $191.62	Facility		$18.97	$191.62	$191.62
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $17.98 / $181.65 / $245.77	Professional		$17.98	$181.65	$245.77
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $213.71 / $213.71 / $213.71	Facility		$213.71	$213.71	$213.71
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $14.63 / $14.63 / $17.80	Professional		$14.63	$14.63	$17.80
United Facility/Professional Professional Modifier Low / Median / High Price $85.80 / $92.80 / $162.40	Professional		$85.80	$92.80	$162.40
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $133.79 / $133.79 / $133.79	Professional		$133.79	$133.79	$133.79